In case you need more proof that the U.S. healthcare system is broken

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[Alex]

My ex-girlfriend just got notified that her family's health insurance had been canceled.  (This is for a healthy family with no chronic conditions and no unusual or expensive claims.)

The insurance company sent her bills -- and she paid the bills on time and paid the amount on the bills.

But the insurance company billed her for one cent less than the premiums were supposed to be.

After five months, they told her that she had not paid her premiums and they were canceling her policy (for an underpayment amount totaling five cents -- even though she paid them everything they billed her for.

This was clearly the insurance company's fault (and involves an amount that is eclipsed by the cost of mailing the cancellation letter), but even after hours on the phone with her, the insurance company won't budge.

Think of this next time you hear anyone say that the current system works fine or that we should let the insurance companies regulate themselves.


(I'm sure the policy will eventually be reinstated... but probably only after spending dozens of hours on the phone or writing letters or contacting attorneys or the state insurance commissioner.  This also illustrates the problem too many companies have with customer service: their first reaction is to say no unreasonably and refuse to look at the context.)

[Bear Woman]

Good luck to your ex-girlfriend's family.  I hope they have either obtained other insurance or nothing happens while they are uninsured. 

Perhaps she can ask to speak to the customer service rep's supervisor?  Sometimes "going up the chain" helps..... 

In the meantime, she should fax and e-mail the appeals person/address asap.

sorry, I know you are advising them well.   

[daMamma]

I haven't seen that before on healthy people.  Have seen it on those that have used their insurance because of serious illness. 

If I've said it once, I've said it a thousand times, and probably will ten thousand more.

Profit before people.  They are in business to MAKE money, not spend it on those sick people.   

[pacos_gal]

Can she go with a different company and file a complaint with the insurance commission about the company she was with?
I'm not sure I would trust that company again after they did something like this.

[Alex]

Can she go with a different company and file a complaint with the insurance commission about the company she was with?
I'm not sure I would trust that company again after they did something like this.

Possibly.  But this isn't a company policy, it's on the "individual market" and the application process alone is extremely complicated (and sometimes requires 3-8 weeks before applications are approved or declined).

Some individual market policy applications literally seem like they were designed by lunatics.  I had to fill one out once that was literally 35 pages and one of the questions was "list every physician you have seen, why you saw that physician, what the diagnosis was, and what the outcome was."  Yes, they wanted every single time you'd been to a doctor in your entire life.  (And, of course, if you left any out, that would be enough to drop you or deny claims later on.)

[pacos_gal]

Good Grief!   

Okay, so maybe go for reinstatement, file a complaint, and start looking for another company after the other has been reinstated and their is time to search while still under coverage. I'm just thinking long term, that this company is not trust worthy.  Would not like to see them getting messed with in the future because they are on some company list of delinquent clients (even though no fault of their own)

Might want to consider sending the information to state rep/senators. 

[daMamma]

This sort of behaviour has been standard operating procedure with auto/home insurance industry for decades, it is now SOP for the health insurance industry.  If her Rep or Senator is Republican they won't care, if they are Dems, well now that's 50/50 whether they'd really care or not.

The whole darn system is broken.