Holy cow ... sometimes being unwilling to "let it go" pays off!
I got the mail tonight and the cheapo medigap insurance company capitulated!!! They paid the claims they were supposed to pay. Unfortunately, they paid the providers (who had already been paid) so we'll have to wait for the providers to refund us the money. BUT ... they paid!!! And it was more than I thought it was ... about $1,500.
I think the magic words I used in my last letter to them was that what they were doing was Medicare fraud and I would be filing agency complaints. What a pity that it took such words to push them into action.
Meanwhile, there are others out there that are being cheated and they don't even know it. I sure hope the agencies I complained to will not treat this as a "closed case" and still investigate this company.
I also hope I have helped someone who is reading this blog to learn how to deal with insurance companies. Keep reading the statements they send to you. You have to work at understanding the statements and if it doesn't add up ... challenge the company. Use the threat of involving state and federal agencies to support your case.
Clearly, if I had been wrong about their processing of the claims they wouldn't have paid them.
Here's the crazy part ... no explanation, no apology ... just a bunch of processing forms arrived that showed they paid a bunch of doctors money. How guilty is that?
Beware ... insurance companies are ruthless.
Update: The cheapo insurance company sent a letter on December 24, 2014 explaining what happened. They said they made a "clerical error". They said they provided a more detailed explanation to the NYS Department of Insurance and have recalculated the deductible. Those rascally clerical errors and incompetent clerks just cannot be trusted.
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