by Guest » Mon Sep 29, 2008 04:12 pm
Over the past year, I have received numerous (7-8) letters in the mail with explanations of benefits for care I did not receive. This includes office vists, surgeries, pathology charges, etc.
I have spoken with customer service and the supervisor of my insurance carrier on numerous occasions expressing that these are incorrect and possibly fraudulent. Each time, they reassured me they would remove the claims and correct the error, but without fail, I received another letter within a few weeks with an incorrect claim in my name.
I thought I finally had this issue resolved a few months ago when I spoke with the supervisor and she said that an office had incorrectly used my ID number. However, I again received a letter with an incorrect claim under my name yesterday. The surprising thing is that I no longer even have insurance under this carrier.
I am incredibly frustrated by the whole thing. I am very concerned that all this care is being documented under my name, and continues while I don't even have insurance with this carrier.
Whom can I contact aside from my carrier to end this and also get a listing of ALL claims under my name from this carrier to ensure nothing incorrect or fraudulent is under my name.
Thanks in advance!
I have spoken with customer service and the supervisor of my insurance carrier on numerous occasions expressing that these are incorrect and possibly fraudulent. Each time, they reassured me they would remove the claims and correct the error, but without fail, I received another letter within a few weeks with an incorrect claim in my name.
I thought I finally had this issue resolved a few months ago when I spoke with the supervisor and she said that an office had incorrectly used my ID number. However, I again received a letter with an incorrect claim under my name yesterday. The surprising thing is that I no longer even have insurance under this carrier.
I am incredibly frustrated by the whole thing. I am very concerned that all this care is being documented under my name, and continues while I don't even have insurance with this carrier.
Whom can I contact aside from my carrier to end this and also get a listing of ALL claims under my name from this carrier to ensure nothing incorrect or fraudulent is under my name.
Thanks in advance!
Posted: Tue Sep 30, 2008 06:42 am Post Subject:
You surely weren't a victim of identity theft, right? If you've been subjected to identity theft you are required to inform the insurance company regarding that and have to request them to stop proceedings against this claim. However, if you have already done that, but haven't received any favorable action from the carrier, you're then requited to file a complaint against the insurer with your state's Insurance Department.
However, you may ask your present insurance agent about the impacts of the wrong claim upon your future insurability.
Thanks,
Rupert
Posted: Tue Sep 30, 2008 06:57 am Post Subject:
I'd suggest that you send them a letter through the registered post and maintain a log of all the conversation that may take place between you and the insurance company regarding this issue. These will act as your supportive document at the event of filing complaint against the insurer.
Some states allow the policy holders to file complaints online. Try to locate the insurance department's website and check for this provision.
BTW, have you received any settlement amount for this claim?
Posted: Tue Sep 30, 2008 10:16 am Post Subject:
You have every right to be very very concerned about this..I'm with Jeorge with one exception, I'd call that carrier, get as high up on the ladder (authority wise) as I could tell them the issue what I want, and give them a time limit to get it to you, advising them you will be filing a dept of ins complaint if you do not receive this information within that time limit..
On the upside, atleast you know this is happening...and hopefully can correct it, were you not receiving these e.o.b. you'd have never known, until something unfortunate occured...
Please let us know the outcome and if we can provide any additional assistance.
Posted: Tue Sep 30, 2008 06:55 pm Post Subject:
Perhaps something as comparing your EOBs to the actual times you went to the doctor? Cross reference the appointment book.
Surely, if you didn't even make an appointment with a certain doctor but the EOB states you were there, that should be fixed rather easily.
And yes, I called you surely.
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