Insurance denies coverage

[Still Learning]

Responsibility of insurance co

QUOTE]Originally posted by Still Learning
What is the responsibility of the insurance company in this case. They were given all necessary information and an authorization to collect. They issued a receipt and a policy. The payment was good. What is their excuse for not collecting it, and will it stand up in court as a reason for denying coverage.


Answer: Call them and ask them.

I am asking on this forum whether their failure to collect on a valid approved credit card transaction will stand up in court as a reason to deny coverage. I realize that you are not a lawyer, SusieBaby. Don't try to answer any more.



By the way, I purchased similar insurance from the same agent last year. I went to the office, filled out the forms, gave my credit card, they called to process it, they issued a receipt and a policy and gave me instructions for filing a claim. I filed claims, and got postcards back saying they were being processed. It took months before I got reimbursed, but I did get checks. I had no reason to suspect that it would be any different this year.


Answer: They must have charged your credit card, did you check? Did you pay the credit charge back?

Of course they charged my credit card. No I didn't check. I don't know what you mean by the question of "paying the credit charge back". If you mean, do I pay my credit card bills, yes, I pay all my bills in full every month. I'm starting to find this a bit silly, to be honest. They say the law is constructed for criminals, and normal law-abiding tax-paying hard-working people better stay clear of it. Amen.


Re the suggestion that the State pick up the tab. Why should taxpayers be expected to pay when I have purchased insurance for this? [/QUOTE]


But you didn't purchase it - thats the point.

Yes I did. THAT is the point. I went through all of the steps exactly as in previous years, exactly as in any other transaction. I filled out the forms. I provided a valid means of payment. The sales contract was fulfilled. If it had been a car, I'd be driving it. Simple as that.

You seem to be saying that if you bought a car from me and gave me $500, but I left it sitting on the table or dropped it on the sidewalk, the sale is not valid. I disagree. Since you aren't a lawyer and neither am I, let's just agree to disagree. Thank you for taking the time to provide me with your opinion.

I violently disagree that taxpayers should be expected to pay for medical bills to compensate for sloppy insurance office procedures. It was obviously my intent that the insurance agent collect the authorized charge to my credit card. They should not be permitted to deny coverage because they "forgot" to do so, and put the burden on the State. That's ridiculous. I don't pay taxes so that insurance companies can "forget" to complete credit card transactions and wiggle out of paying claims.


Just offering you some alternatives to a policy that was never in effect.

Do you suppose that Medicaid would provide legal assistance in this case in order to prevent it from becoming a State issue? I am a responsible citizen. I purchased insurance in order NOT to be a burden on the state welfare agencies. Your "solution" is a clear example to me of what is wrong in America today.

If you don't have insurance these days, hospital bills can put you into bankruptcy real quick.

Correct. That is the reason for my question.

 

[Souix]

Re: Responsibility of insurance co

QUOTE]Originally posted by Still Learning
What is the responsibility of the insurance company in this case. They were given all necessary information and an authorization to collect. They issued a receipt and a policy. The payment was good. What is their excuse for not collecting it, and will it stand up in court as a reason for denying coverage.


Answer: Call them and ask them.

I am asking on this forum whether their failure to collect on a valid approved credit card transaction will stand up in court as a reason to deny coverage. I realize that you are not a lawyer, SusieBaby. Don't try to answer any more.



By the way, I purchased similar insurance from the same agent last year. I went to the office, filled out the forms, gave my credit card, they called to process it, they issued a receipt and a policy and gave me instructions for filing a claim. I filed claims, and got postcards back saying they were being processed. It took months before I got reimbursed, but I did get checks. I had no reason to suspect that it would be any different this year.


Answer: They must have charged your credit card, did you check? Did you pay the credit charge back?

Of course they charged my credit card. No I didn't check. I don't know what you mean by the question of "paying the credit charge back". If you mean, do I pay my credit card bills, yes, I pay all my bills in full every month. I'm starting to find this a bit silly, to be honest. They say the law is constructed for criminals, and normal law-abiding tax-paying hard-working people better stay clear of it. Amen.


Re the suggestion that the State pick up the tab. Why should taxpayers be expected to pay when I have purchased insurance for this?

But you didn't purchase it - thats the point.

Yes I did. THAT is the point. I went through all of the steps exactly as in previous years, exactly as in any other transaction. I filled out the forms. I provided a valid means of payment. The sales contract was fulfilled. If it had been a car, I'd be driving it. Simple as that.

You seem to be saying that if you bought a car from me and gave me $500, but I left it sitting on the table or dropped it on the sidewalk, the sale is not valid. I disagree. Since you aren't a lawyer and neither am I, let's just agree to disagree. Thank you for taking the time to provide me with your opinion.

I violently disagree that taxpayers should be expected to pay for medical bills to compensate for sloppy insurance office procedures. It was obviously my intent that the insurance agent collect the authorized charge to my credit card. They should not be permitted to deny coverage because they "forgot" to do so, and put the burden on the State. That's ridiculous. I don't pay taxes so that insurance companies can "forget" to complete credit card transactions and wiggle out of paying claims.


Just offering you some alternatives to a policy that was never in effect.

Do you suppose that Medicaid would provide legal assistance in this case in order to prevent it from becoming a State issue? I am a responsible citizen. I purchased insurance in order NOT to be a burden on the state welfare agencies. Your "solution" is a clear example to me of what is wrong in America today.

If you don't have insurance these days, hospital bills can put you into bankruptcy real quick.

Correct. That is the reason for my question. [/QUOTE]



This is all so simple its stupid. I'm going to give you the benefit of the doubt and not accuse you of insurance fraud or calling you "Still Scamming".

You stated in a previous post (I am unsure of which one because you double posted and changed your story) that your credit card declined the charge. If you had been paying attention to your bills, you would have seen that there was no charge on your billing. A responsible person or citizen as you call yourself, would have called the insurance company to find out why your credit card had not been charged for the premium. At that time a "responsible person" would have known that he/she did not have coverage because the credit card company declined it.

So now you have the uncomfortable job of calling the insurance agent to find out what happened (7 months later). I do feel that the insurance agent should have called you sooner, but you also have the responsibility to make sure things were proceeding as you thought. In fact, the insurance company could claim you breached the contract because your credit card company declined the charge.

Good Luck to you, I hope you figure something out.

 

[Still Learning]

you all need reading lessons

You guys have very poor reading skills!! Check again.

My credit card did not decline the charge. I can prove that. The insurance company never processed it, after obtaining the authorization for it. Thank God I have a decent credit card company that keeps records.

Thanks to those who tried to give some useful advice.

 

[Souix]

Re: you all need reading lessons

You guys have very poor reading skills!! Check again.

My credit card did not decline the charge. I can prove that. The insurance company never processed it, after obtaining the authorization for it. Thank God I have a decent credit card company that keeps records.

Thanks to those who tried to give some useful advice.

Re-read your first post https://forum.freeadvice.com/showthread.php?s=&threadid=134780

Did you not write that?

 

[Still Learning]

Please read carefully

Please read it again carefully. Maybe with a dictionary. Pay attention to the main ideas, the verbs, the subjects of the sentences. You will get it if you try. Some hints: What did the insurance company say? Was it true?

 

[JETX]

Gee, since you got caught in your first attempt to scam, you have now changed your story to include:
1) You had purchased insurance from them before and had no problem, and
2) You now claim to have proof of the charge card transaction.

Okay, then that makes this VERY, VERY simple.
Take your proof of payment down to the insurance agents office and show him/her that you did pay for the insurance. If they still refuse, file a lawsuit.
Case closed.
Have a nice day.
Bub-bye!

 

[Souix]

Re: Please read carefully

Please read it again carefully. Maybe with a dictionary. Pay attention to the main ideas, the verbs, the subjects of the sentences. You will get it if you try. Some hints: What did the insurance company say? Was it true?

Your story has changed so much its hard to tell what is what. I hope you have better communication skills when you speak to the attorney you hire and you don't lose too much money over this. Hint: Keep your story straight and maybe someone will believe you. Good Luck (I think you're going to need it)

 

[Still Learning]

Now I am really laughing

This is hilariousl!! First I have a realtor trying to give legal advice about insurance (a harmless enough hobby, I suppose), and then this guy who can't read.

I have not changed my story. You seem unable to read for detail.

I said: My credit card did not deny the charge. They can prove that they did not. In other words, the insurance company cannot claim that they tried to process the transaction and it was denied. It was not denied. IT WAS NEVER PROCESSED. Look that up in your dictionary. I keep saying this and you keep missing it. I have proof from the credit card company that they authorized the charge, gave an authorization number for them to process the charge, and the company never completed the transaction.


Reading 101 prescribed for Susie and Jet. Jet also needs to learn more about how credit card transactions are processed in order to give proper legal cousel.



Gee, since you got caught in your first attempt to scam,

What, are you trying to goad me into threatening to sue you or something? This is childish and ridiculous. Let me call you a few choice names now. Let's try incompetent. Let's try cowardly, like everyone who gets on a public forum on the internet so they can hide behind phony names while they are rude and aggressive and put their worst behavior on parade. Ok, that's enough. I am not good at this. It's not how I was raised.


you have now changed your story to include:
1) You had purchased insurance from them before and had no problem,

This is an addition, not a change. It wasn't relevant to my question, which no-one has answered, about the legal status of a credit card transaction.

and
2) You now claim to have proof of the charge card transaction.


No, I did not say that. I keep telling you. I have proof that I presented a valid payment, a valid credit card with sufficient credit limit and perfect record, the charge was authorized by the credit card company, they have a record of it, and the insurance did not complete the authorized transaction.

Glad I am not your client. I now have a lawyer with a few brains who seems to have no trouble comprehending this, God bless him.

have a nice day.

 

[Still Learning]

How Credit Cards Work

Here, for the benefit of Susie and Jet, is a description of how credit cards work.

Let's say the Jet and Susie go buy groceries and pay with their Visa cards.

Jet has $10 of cheap beer. He give the cashier his Visa card, and she swipes it in a card reader, which sends a message to Visa requesting authorization. Visa checks to see if
1. the number is a valid card
2. the cardholder is in good standing
3. the new charge, when added to current balance and outstanding charges, will not take the card over the credit limit.

Unfortunately, the answer comes back "denied". Jet has to pay cash for his groceries, or leave them behind.

Susie has an armful of gossip magazines and some nailpolish for $20. She gives the clerk her Visa card, and the cashier scans it and Visa checks it as above.

Since Susie is in good standing, and under her credit limit, the answer comes bacK: Aprroved!! Authization code k06xyz6.

So Susie signs and takes her groceries. The sale has completed.


Later, the supermarket will send an invoice to Visa for all of the credit charges they received on Visa cards, in a format like this:

credit card number authorization code amount
586858483939 k06xyz6 $20
868584857939 mgm5m $80
Total: $100

Visa will pay the supermarket $100. Visa will add the $20 charge to Susie's bill. They will cancel the authorization code and replace the "authorized charge" with the "actual charge".

Note that the credit card company keeps a record of authorized charges and adds all authorized charges to the current balance for the purpose of calculating how close you are to your credit limit. The amount billed by the merchant is compared to the amount authorized, and the authorization is cancelled after it has been billed by the merchant.

Here is my point. You get to take your groceries home when your credit card has been approved. That is the point when the sale is complete from your side. If the supermarket never bills Visa, it isn't your problem.


Hope this helpes.

 

[Souix]

Re: How Credit Cards Work

Here, for the benefit of Susie and Jet, is a description of how credit cards work.

Let's say the Jet and Susie go buy groceries and pay with their Visa cards.

Jet has $10 of cheap beer. He give the cashier his Visa card, and she swipes it in a card reader, which sends a message to Visa requesting authorization. Visa checks to see if
1. the number is a valid card
2. the cardholder is in good standing
3. the new charge, when added to current balance and outstanding charges, will not take the card over the credit limit.

Unfortunately, the answer comes back "denied". Jet has to pay cash for his groceries, or leave them behind.

Susie has an armful of gossip magazines and some nailpolish for $20. She gives the clerk her Visa card, and the cashier scans it and Visa checks it as above.

Since Susie is in good standing, and under her credit limit, the answer comes bacK: Aprroved!! Authization code k06xyz6.

So Susie signs and takes her groceries. The sale has completed.


Later, the supermarket will send an invoice to Visa for all of the credit charges they received on Visa cards, in a format like this:

credit card number authorization code amount
586858483939 k06xyz6 $20
868584857939 mgm5m $80
Total: $100

Visa will pay the supermarket $100. Visa will add the $20 charge to Susie's bill. They will cancel the authorization code and replace the "authorized charge" with the "actual charge".

Note that the credit card company keeps a record of authorized charges and adds all authorized charges to the current balance for the purpose of calculating how close you are to your credit limit. The amount billed by the merchant is compared to the amount authorized, and the authorization is cancelled after it has been billed by the merchant.

Here is my point. You get to take your groceries home when your credit card has been approved. That is the point when the sale is complete from your side. If the supermarket never bills Visa, it isn't your problem.


Hope this helpes.

Gee you must have a lot of time on your hands to post all of that. Go back and read what you wrote in the Consumer Complaints Section and then re-read this thread and tell us you have not changed your story. The real issue here is that YOU did not notice that the insurance company DID NOT charge your card on YOUR statement. You scan your card for "illigitimate charges" but you neglected to scan it for the insurance company charges. And...."no one noticed" including yourself. I still maintain that if you had noticed that back in September, you could have remedied the situation a long time ago and you would not have this mess you are in now.

 

[JETX]

For someone who claims that others can't read, you seem to be missing the best free advice you will ever receive.

Let me repeat it here:

"Take your proof of payment down to the insurance agents office and show him/her that you did pay for the insurance. If they still refuse, file a lawsuit.
Case closed.
Have a nice day.
Bub-bye!"

I think even you can read that one.

And finally, if the insurance company "did not complete the transaction" (your words), the contract was never completed.... and they have no obligation to you.

 

[Still Learning]

Susie Baby stick to real estate

Susie, sweetie, please stick to real estate. I appreciate your desire to give this "mommy knows best" kind of advice on a legal forum, but it isn't as useful as you think it is.

Re-read my posts. There is nothing contradictory. I think YOU misunderstood something in one of the initial posts, and now every time I repeat it, you think it's me contradicting myself, when in fact I am merely contradicting YOUR misinterpretation every time I try to explain the same thing over and over. Check it and see.

You seem to persist in missing the whole point, but it doesn't matter now whether you understand the issue or not. I have what I need from the credit company and a competent lawyer who agrees that the sale was completed when the credit card issued the authorization.

I hope the real estate business picks up for you there in Oregon.

 

[Still Learning]

here is the point

For someone who claims that others can't read, you seem to be missing the best free advice you will ever receive.

Let me repeat it here:

"Take your proof of payment down to the insurance agents office and show him/her that you did pay for the insurance. If they still refuse, file a lawsuit.

In progress. I think I came up with this idea all by myself.

And finally, if the insurance company "did not complete the transaction" (your words), the contract was never completed.... and they have no obligation to you.

No, this is the point that I am contesting. Their transaction WITH ME was completed when they received the authorization from the credit card, and they issued the policy and my receipt because they also recognized that. I presented a valid payment. See my example of a commercial transaction. They get the authorization code and I get my groceries. The authorization code is as good as cash.

The fact that they did not complete the transaction WITH THE CREDIT COMPANY is a different matter and beyond my control.

 

[Souix]

Re: Susie Baby stick to real estate

Susie, sweetie, please stick to real estate. I appreciate your desire to give this "mommy knows best" kind of advice on a legal forum, but it isn't as useful as you think it is.


You are probably right, Still Scamming =) I just don't understand scam artists I guess *sigh*.


Re-read my posts. There is nothing contradictory. I think YOU misunderstood something in one of the initial posts, and now every time I repeat it, you think it's me contradicting myself, when in fact I am merely contradicting YOUR misinterpretation every time I try to explain the same thing over and over. Check it and see.


If you feel you are right, and you did not double post and contradict yourself over and over again, why do you keep coming back here and arguing the point?


You seem to persist in missing the whole point, but it doesn't matter now whether you understand the issue or not. I have what I need from the credit company and a competent lawyer who agrees that the sale was completed when the credit card issued the authorization.

Good for you

I hope the real estate business picks up for you there in Oregon.

Thank you.

 

[crusheroz]

I have been reading your post, and I have to say this: Your approval code, authorization number will not hold up. The Insurance company made a mistake a DID NOT process your card or maybe the credit card company system was down for maintance or updating and the charge did not go thru. If it happened that way, it could have come back declined. Therefore you never really paid for the insurance, therefore you are not covered. If you had checked your statement you would have noticed that it never charged. Or you noticed that it never charged and hoped you had gotten free insurance coverage. That is why you always double check everything. I had a similar thing happen to me a couple of years ago, I paid a bill with my debit/credit card, got the approval code, but for some reason the transaction never posted to my account. Here is where common sense kicks in, IF IT DOES NOT POST, YOU DID NOT PAY FOR IT! Therefore, I had to repay the bill. All the approval code did for me was it proved I attempted to pay the bill, so I was not charged a late payment fee.