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As a broker, we work for our customers, not for the insurance companies.
We all the time help our customers in case they are having trouble with the claims. That is misunderstood by some people.
We help our customers if they are having some trouble with claim such as paper being missed, miscommunication, confusion, misunderstanding between customer and insurance company, and of course, if it is not clear whether something was pre-existing conditions or not or if we feel that the condition may not be pre-existing.
That does NOT mean that we would help all our customers getting their claims approved no matter what the problem is.
I just talked with a lady earlier today. His father in law had a history of heart disease and had angioplasty perforemed before. Even though I don't know all the medical details, from what she described over the phone, he got chest pain, essentially, recurrence of heart disease. That is very clearly pre-existing condition and insurance company correctly declined the claim.
Now she wanted me to help her appealing the denial and was arguing that we claim we help our customers with the claims. As I already know that her father-in-law had previous heart disease, there are no further arguments I can provide to the insurance company that would justify the potential reversal of the claims.
I thought I would post this message so that customers can get realistic idea of how exactly it works.
We all the time help our customers in case they are having trouble with the claims. That is misunderstood by some people.
We help our customers if they are having some trouble with claim such as paper being missed, miscommunication, confusion, misunderstanding between customer and insurance company, and of course, if it is not clear whether something was pre-existing conditions or not or if we feel that the condition may not be pre-existing.
That does NOT mean that we would help all our customers getting their claims approved no matter what the problem is.
I just talked with a lady earlier today. His father in law had a history of heart disease and had angioplasty perforemed before. Even though I don't know all the medical details, from what she described over the phone, he got chest pain, essentially, recurrence of heart disease. That is very clearly pre-existing condition and insurance company correctly declined the claim.
Now she wanted me to help her appealing the denial and was arguing that we claim we help our customers with the claims. As I already know that her father-in-law had previous heart disease, there are no further arguments I can provide to the insurance company that would justify the potential reversal of the claims.
I thought I would post this message so that customers can get realistic idea of how exactly it works.
