Insurance fraud

[Taylortractornut]

I had a fender bender the otherday a fella with tail light covers did a brake check and both vehicles were doing 15 mph. I tailended this kid on his way to vo tech. He let me know his uncles one had a body shop a few towns over and the other worked as head af a GM dealership. Well his dad called you can tell the way he ho hummed around with quotes like it messed it all up under the truck, and my custom exhaust need both pipes replaced I started to smell the vaseline.
At the scene of the wreck i climbed under the truck and looked it over. I bent the right tailpipen bumper, and the panel behind the bumper. Its one of those custom trucks like a 93 Chevy stepside v6 trucks like a Southern Comfort edition. When i looked under it it was bent in the rear and the tip need replaced not even a true dual exhaust. Well the same fella called from the insurance office with his estimates for true duals he claims to have replace all the exhaust hangers, replace the bumper the sheet metal behind it, relign the front end, and is now claiming since the paint on the truck is losing the clearcoat it wont match the new paint on the panel behind the bumper so he wants that fixed to. He said he took the estimates at the GM ealership, and the other at a body shop in the same town a Baldwyn the same town as his brotherinlaws shop. One was 1280 ,and the other was 2000. Is there some way i can have the insurance company have there people give an estimate? I had a freind that used to work for the insurance cmpany tell me that some folks take there cars to a body shop a freind has and gets a very high estimate then gets the work done and when its over they get enough money to paint the truck and do more to it than it needed. I hate to pick knits but the more i think about it the worse it bothers me about his attitude. Tayke care Taylor Lambert

 

[Anonymous Poster]

Are you paying for this out of your own pocket? If your insurance company is handling this, I wouldn't have any contact with the injured party. The insurance company will send one of their adjusters to look at the vehicle and decide if the repair costs are justified.

 

[Taylortractornut]

THe insurance company is now handling it he had gtotten esdtimates from his freinds. I figure since im paying it ill let them handle the headaches. Since i told him the insurance company has there hands in it hes called 3 times trying to get me to pay out of my pocket alot less than the quoted estimates before the adjuster comes by his place. I wanted to keep it off the insurance books because of my future CDL's but my agent told me that it wont be too big of an increase.

 

[cowboydoc]

Your insurance company will send an adjuster out to look at it. They will then pay for what they find is wrong with it. He's trying to get you to pay out of pocket because he knows he was trying to screw you. And people wonder why our insurance rates are out of this world.

 

[Anonymous Poster]

I agree with you Richard....People that trys to operate that way are losers in my opinion!!!!!!!!!
Honesty is always the best policy.........................In anything you do.If I am at a cash register buying something and they over refund me or I find out they undercharge me....either way I try to make it right,I don't care if it is only a penny.
I sleep well at night. /forums/images/graemlins/wink.gif

 

[Bird]

Me, too, Fred. No matter whose error the favor is in, I want it corrected. It's amazing how many, both individuals and organizations, will try to "fudge" a little. My wife had a routine mammogram last month and I just got the itemized bill; $118 for the mammogram and $82.17 for "100mg/100ml morphine". /forums/images/graemlins/shocked.gif Since the insurance company has already paid their share and what they're asking from us is a small amount, I guess they figured we'd just pay it, but I called and they said that some women find it painful enough that a little sedative is used. Of course my wife says she's never received any kind of medication just to have a mammogram.

I figure there's three possibilities:
1) honest mistake,
2) medical center cheating insurance companies and patients, or
3) narcotics thief working there and trying to cover the thefts by billing patients for things he/she stole.

Wish I knew which it was, but anyway they said they'd sent me a form to fill out and return requesting an "audit."

 

[Anonymous Poster]

Bird, in the polite venacular of the medical billing world, it's called COST SHIFTING. The system bills everyone for morphine, an interesting concept since most hospitals aovid usime morphie till post surgery, and has learned less than 1% of people are going to read the bill, understand what they read, and complain.
Now, you're about to experience the FUN of trying to get the bill corrected. The provider will make the correction process as difficult as they can, figuring to exasperate you into paying.
COST SHIFTING is a wonderful income source for providers,as is billing for items not delivered. Carriers know they are getting ripped off, and run a cost benefit analisys to determine if the ripoff is cheaper to pay or contest. From a carrier standpoint, it is probably economicly justified, after all, they will just pass along toe cost to us consumers anyhow, but it flat pi$$es me off. A few years ago, I spent a lot of hours fighting both the carrier and providers over about $400- in charges, but since I was laid up anyhow, the time was available, and I was enjoying the fight. My wife became thoroughly convinced I am nuts, because it would have been cheaper to just pay the bill. After 6 months, I won, and when I called the insurance carrier to ask if they were going to recover what they had improperly paid, they told me it wasn't worth it. Nice system they've developed.

 

[Bird]

Yep, Franz, AARP published an article a few months ago in their magazine. I don't remember the details, but the bottom line was that less than 10% of the hospital bills they checked did not have errors. And you're right; in this particular case, my cost is less than $20 so it would probably be easier to just pay it, but like you, that just ain't the way I do things. /forums/images/graemlins/laugh.gif

 

[BigDave]

I agree 100%.

I will correct any type error regardless of who it favors. Last week, we bought a shopping cart full of groceries, and when we were putting the items into the trunk when I realized the Kitty Litter was still underneath the shopping cart. I checked the receipt, and yup the casheir overlooked this item. I told my wife I was going back into the store to pay for the litter. She said come on let's just go, but I just grabbed the 25lb pail and lugged it back into the store. I waited in line again, and paid for the litter. At least this time I got to go through the express line. /forums/images/graemlins/wink.gif

The misses was waiting in the car when I returned, and rather than being mad, she told me I was a good man. /forums/images/graemlins/smile.gif

 

[Gary_in_Indiana]

Bird,

I had a similar billing experience a few years ago. I'd had another knee surgery (# 5, 6, or 7... I can't remember) and was doing physical therapy three days a week at their facility.

I'm sent copies of bills monthly and they look approximately the size of the Dead Sea scrolls. They are simply a list of dates and charges but, at three a week the list grows rapidly. Most of the stuff I understood to one extent or another except one item which appeared every day;

Cryotherapy.................. $94.00

Obviously I knew what 'therapy' was. 'Cryo' was a prefix I'd only heard in science fiction movies about freezing people to bring them back from the dead later ('cryogenics').

After a few phone calls I got my answer. I was being charged $94.00 for saying "OK" when someone offered me a small plastic trash can liner full of crushed ice from a restuarant style ice machine they had there.

The fact of the matter was I lived about four blocks from that facility and used to walk there and back and have ice at home. When I pointed out that fact I was told not to worry about it because my insurance covered it!

I explained that I was paying for it one way or the other and found what they had done to be misleading at best and likely out and out fraud. Getting nowhere with the billing department, I spoke with the hospital administrator who had all of those charges removed.

I had to wonder how many hundred people had been billed how many thousands of dollars for a little bag of ice.