05 Mar Reason #57 that I hate insurance

Reason #57 that I hate insurance: the stupidity, mixed with arrogance, exhibited by all carriers. Today’s example is Blue Shield. A client signed up effective January 2014. To date, they’ve made 16 payments and had one payment refunded back (for no known reason). To me, that says they’ve made 15 payments, which has them paid through March, 2015. But for the last 7 months the carrier has been saying the client is a month behind and is in danger of being cancelled.

A client signed up effective January 2014. To date, they’ve made 16 payments and had one payment refunded back (for no known reason). To me, that says they’ve made 15 payments, which has them paid through March, 2015. But for the last 7 months the carrier has been saying the client is a month behind and is in danger of being cancelled.

On four separate occasions I’ve sent them copies of the client’s credit card statements showing all the drafts, along with a copy of the check that the carrier sent back to them (again, no one seems to understand why this check was sent to them…which I find slightly scary). ¬†Each time the rep I’m working with says something like, “hmmm, I see what you’re saying, it looks like we’re missing a payment in our system somewhere.” Two weeks later my client receives a letter saying “You’re payment is later and your insurance is being canceled…”, but of course they aren’t late, the books are just still screwed up. The rep I spoke to is nowhere to be found and doesn’t respond to either voicemails or emails.

Finally, I get the case ‘escalated’ to Management level. After leaving several messages, I get an email that tersely says, “This is our final accounting of this account, as it is accurate and we deem that it cannot be further appealed or reviewed”. It shows 14 payments over 15 months, therefore the client is 1 payment behind. That’s great, but it completely ignores 2 payments and the mystery refund all made in December, 2013. So, their “this is right and we don’t want to talk about it anymore” accounting is wrong…and not wrong in a really tricky, higher-math, kind of way, but in a “hey, you forgot to list a few payments made” kind of way.

So, I wait on hold, get transferred twice, and spend almost 2 hours on the phone with them just to get them to compare their faulty accounting to the list of drafts made from my client’s credit card. And they’ve deemed, in their generosity, to reopen the file and look again. But it still isn’t fixed!!

Why is it that every single time they make a mistake, it’s in their favor and not the consumer’s? Every. Single. Time.

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