Complaint Review: STATE FARM INSURANCE COMPANY - Internet
- STATE FARM INSURANCE COMPANY www.statefarm.com Internet United States of America
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- Category: Health Insurance
STATE FARM INSURANCE COMPANY State Farm 20 year customer denied valid claim Internet
*Consumer Suggestion: I hope this helps you
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I've been a State Farm customer for 20 years. Had home, car, and health insurance with them. I was sold hospitalization expense insurance by agent (wife of owner agent). She said "this is the best insurance around... they wrote Bob a check when he had his heart attack".
I filed a claim for a hernia after going to the emergency room. It was denied because the lady that filed the report at the agents office put "stomach pain" for the cause. Seeing the error, I got the medical report from the hospital. I took it back into the agent with the Hernia underlined to resubmit. I received a letter from the CO office stating it was again rejected for "stomach pain". I sent the CO office a letter explaining that it was input in the system as stomach pain by the agents office person and that the report from the doctor clearly showed a hernia. It was again rejected.
The issue is that they input it wrong in the system. And no one will take the time to actually READ the report from the doctor that shows what's wrong. State Farm claims that "stomach pain" is not covered... but an accident like pulling a hernia is.
State Farm and this agent Bob Hollingsworth has lost a 20 year customer because of this. I can somewhat understand the first mistake, but now I've given them 4 times to make it right and neither State Farm nor the Agent (or his employees) will take the time to make this right. I have cancelled all my insurance with them and have gotten the same insurances cheaper from another company (local agents as well).
No wonder people hate Insurance companies as much as lawyers now a days.
This report was posted on Ripoff Report on 10/06/2009 02:55 PM and is a permanent record located here: https://www.ripoffreport.com/reports/state-farm-insurance-company/internet/state-farm-insurance-company-state-farm-20-year-customer-denied-valid-claim-internet-505315. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content
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#1 Consumer Suggestion
I hope this helps you
AUTHOR: FusedGal - (United States of America)
SUBMITTED: Tuesday, August 10, 2010
I can guess what they might have done. State Farm might have had the ER and Hospital file the health claim with the wrong medical code. So even though it says "Hernia" they may have persuaded the Hospital to use a medical code for "stomach pain". That way if it goes to court, they get a Doctor to (LIE) say you only had stomach pain. The Doctor will use the medical code to support his lie. What I suggest you do is this: get all your medical records including all insurance statements that have the medical codes on them. Then check the CPT medical code that was used. Look up the CPT codes online or at the Library medical info databases. If there is a discrepancy, then write a letter to the Hospital and treating physician and request a correction. Send the letter certified mail. Be sure to make copies of everything. Keep the originals in a lock box or safe. I'm not kidding. Insurance companies often conduct surveillance and even have pros break into your home while you are away, at the Doctor or at Physical Therapy. They can attach a GPS to your car, track your cell phone signal and even put surveillance bugs in your home. They have big bucks and will go to any length to make sure claims are not paid. They keep their shareholders happy. I read how the claims adjuster only gets a certain amount per year for claims and if he can deny enough claims he gets a big bonus at the end of the year. Yep, ruthless isn't it? One day, enough people will be angry and a huge class action lawsuit will be filed. Consider filing a FRAUD lawsuit or even file in small claims for fraud. First get the info then proceed. Best to you.


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