Unfiltered Story #143707

, , | Unfiltered | March 17, 2019

(I’m an insurance adjuster. A body shop calls on a Tuesday to ask if we’ve reviewed an estimate so the customer can drop off her car the next day to get the work done. I check the claim and see that the field examiner is scheduled to review the estimate the next day. A little while later, the customer calls.)

Customer: Why is it taking so long to get my car fixed?
Me: As I said when you first made the claim, we just needed to receive the estimate so that our reviewer could check it over.
Customer: But I sent the estimate to my agent two weeks ago!
Me: (checks files) I got the paperwork from the agent yesterday and sent it straight to the reviewer.
Customer: What? How is that possible?
Me: Well, ma’am, your agent doesn’t work for our company so we don’t have access to his files. Did you get the email I sent last week asking if you’d visited the shop yet?
Customer: I just told you, I sent the estimate to my agent! I shouldn’t have to answer your emails.
Me: I also left you a voicemail on Friday to remind you that we hadn’t gotten your estimate and that you needed to contact your body shop.
Customer: I get so many voicemails, I just delete the ones from numbers I don’t know.
Me: Well, the reviewer will be out there tomorrow so you can drop your car off for repairs as planned.
Customer: But it should be fixed already! I sent the estimate to the agent two weeks ago!
(I’m not sure she understands that the agent and the adjuster are two different people!)

Jesus Got Those Abs Somehow

, , , , , | Right | March 14, 2019

Me: “Hello, sir. I’m calling from [Insurance Group], where we have noticed that your current life insurance policy is out of date, or not written into a trust. Do you know if this is correct, or is our system wrong?”

Customer: “Yes, that is correct.”

Me: “Ah, well, I can fix that for you now if you’d like.”

Customer: “Ah, great!

Me: “So, who is your current life insurance provider?”

Customer: “Ah, well, that’s a question for the ages, in fact… JESUS CHRIST IS MY LIFE INSURANCE!”

Me: “Ah, well, does Jesus Christ offer a free gym membership with his current policies?”

Customer: *hangs up*

Copay And Say Over Again

, , , , | Healthy | March 14, 2019

(My insurance company has decided to stop covering one of my prescriptions for unknown reasons. I get a notice from them on a Friday afternoon, as well as an email from the pharmacy, that the prescription in question is due for a refill. Since it’s Friday at three pm, I figure I’ll just pay the cash price for it this month and call my insurance company next week. I click the link in the email to refill and go back to work. An hour later, I get a text update saying the prescription has been put on hold. I call my pharmacy.)

Me: “Hi. My name is [My Name], and I’m calling regarding my prescription I just sent for a refill.”

Rep #1: “Sure, I’ll look at that… Oh, it looks like your insurance won’t cover it for whatever reason.”

Me: “I know. I’ll just pay the cash price this month. How much will it be?”

Rep #1: *timidly* “[Amount].”

Me: “Okay, that’s fine. When can I pick it up?”

Rep #1: “You’re going to pay it?”

Me: “Well, sure. What other option do I have?”

Rep #1: “Oh… okay! I’ll finish it up for you. It should be ready in thirty minutes.”

Me: “Great. Thanks!”

(After I get out of work, I stop by the pharmacy. There’s a different rep behind the counter.)

Me: “Hi, I’m [My Name], and I believe there’s one prescription ready for me.”

Rep #2: “Okay, I see that here. Hmm… looks like there’s a copay.”

Me: “I know.”

Rep #2: “There shouldn’t be.”

Me: “They already told me. [Amount], right?”

Rep #2: “Let me look into this.”

Me: “It’s okay. My insurance company screwed up. I’ll call them on Monday.”

Rep #2: “You shouldn’t have to pay for this. There’s never a copay on [prescription].”

Me: *slightly irritated that he just announced what I’m taking to the entire pharmacy* “It’s fine. Really. Can I just pay?”

Rep #2: “I can give you a discount.”

Me: “The copay’s not that bad. It’s been a long day and I’d really like to pay and go home.”

Rep #2: “If you’re sure… Okay, I’ll put it in. I’ll even throw on that discount. If you want to have a seat, I’ll holler when it’s ready.”

Me: “Uh… the lady I talked to earlier said it’d be ready by now.”

Rep #2: “No, we were waiting until you stopped in. It’ll only be about twenty minutes.”

(I’m extremely annoyed now, but I’m trying my best not to show it.)

Me: “Look, I’ll just come back tomorrow. No problem.”

Rep #2: “It’s only twenty minutes. Maybe less!”

(I wave and walk out. I drive back over the next day, where there is yet another rep behind the counter.)

Me: “Hi, I’m [My Name], and there should be one ready for me.”

Rep #3: “Yes, it’s filled and ready to go. One minute while I grab it!”

(He grabs it and starts ringing me out.)

Rep #3: “Oh, um… I need to get the pharmacist. Something isn’t correct.”

Me: “If it’s the copay, I know about it! It’s not an issue!”

([Rep #3] disappears into the back. I throw up my hands in frustration. He comes back out a few minutes later.)

Rep #3: “There’s a copay on this. There shouldn’t be. We can look into this for you.”

Me: “LISTEN TO ME. You are the third person that I’ve explained this to. I know about the copay. It’s fine. My insurance company screwed up. All I want to do is pay and go home!”

Rep #3: “I apologize for the issue. I don’t know what happened with your insurance… Hold on. Did you say you are going to pay?!

Me: *through gritted teeth* “YES.”

Rep #3: “Oh. OH! Yes, I’d be happy to process that for you! No problem!”

(I can only imagine how many temper tantrums people have thrown over copays to prompt that reaction from THREE pharmacy techs!)

Death Is A Pre-Existing Condition

, , , , , , | Healthy | March 13, 2019

(I work for an insurance company. When people forget or lose their insurance cards, the doctor’s office often calls us to confirm if the insurance is up and running. I get one of these calls.)

Receptionist: “I am calling to confirm the insurance of a patient. It’s [Patient], born [date], living at [address].”

(I look up the data, double checking that I am really talking to a doctor’s office.)

Me: “Yeah, he was insured with us up to [date a few months in the past].”

Receptionist: “Well, do you know where he is insured now? He is sitting here, waiting for treatment.”

Me: “What do you mean, he is sitting there? According to my information, he died a few months ago.”

(Turns out, the doctor had two patients with the same name and birthday, and both were insured with us. And the receptionist called up the file just using that information. Only after we asked the patient for his address did we confirm that he was the other patient. I still wonder what went through his mind when the receptionist told him, “I have your insurance on the line; they say you’re dead.”)

Not Much Assurance About The Insurance, Part 12

, , , , | Working | March 1, 2019

(For a variety of reasons, every year my parents have changed their Medicare supplement insurance. This year they are not changing and I’m not exactly sure of the procedure. I call their insurance company during open enrollment.)

Agent: “Hi, my name is [Agent]. Thank you for calling [Insurance Company]. May I have your member ID number?”

Me: “Sorry, I don’t have that right now. I just have a general question that doesn’t require my account.”

Agent: “Sure. What can I help you with?”

Me: “My parents have [Company] insurance—“

Agent: *interrupts* “I’m sorry, but due to HIPAA regulations, I cannot answer your questions due to privacy concerns.”

Me: “This is a general question that does not require knowing anything personal.”

Agent: “Sorry, I need an authorization.”

Me: “You can’t answer a general question about your company?”

Agent: “Not without an authorization.”

Me: “How about I ask the question and you decide if you need an authorization?”

Agent: “Ma’am, I’ve told you I cannot answer you. Please hold for my supervisor.”

(She puts me on hold and eventually, a supervisor gets on the line.)

Supervisor: “Ma’am, I understand you need information about your parents’ insurance and do not have an authorization?”

Me: “I have a general question about your company that is not specific to any individual.”

Supervisor: “We would need written authorization from the member to answer that.”

Me: “How about I ask the question and then you see if you can answer it?”

Supervisor: “Ma’am, if you want to do that, go ahead, but we are bound by federal HIPAA regulations.”

Me: “Great. Now, my parents currently have insurance with your company. The plan they have will be offered again next year. They do not want to make any changes. Do they need to do anything or will it just renew?”

Supervisor: “If they don’t want to change anything and they do not contact us, they will be automatically renewed. Now, what is your question?”

Me: “That was my question.”

Supervisor: “No, I mean the question about your parents’ coverage.”

Me: “That was it.”

Supervisor: “So, you do not have a specific question?”

Me: “I had a specific question: how do they renew? You said it’s automatic, so I now have the answer to my question.”

Supervisor: “If you do not have a question, I am going to end this call. In the future, please have a signed authorization available before you call. Goodbye.”

(I’m now thinking I should probably have them change to a company with smarter employees.)

Related:
Not Much Assurance About The Insurance, Part 11
Not Much Assurance About The Insurance, Part 10
Not Much Assurance About The Insurance, Part 9

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