Recent Top News
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| Top News Story |
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| Health Insurance: What to Do if a Health Insurance Company Denies Your Claim |
| 6/12/2008 |
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Read and Understand Your Policy
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| Your individual health insurance policy is a
legal contract with an insurance company. It is imperative to read your policy
thoroughly to understand your rights and responsibilities. Your policy will
also detail the medical conditions and benefits for which the insurance company
will and will not pay. If any part of the policy is unclear to you, seek
additional clarification from your insurance agent or company. |
What to Do if a Claim is Denied During Treatment
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| Make a list of questions and immediately contact
your insurance company. You will find contact information on the back of your
insurance card.
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| Keep notes of all conversations you have with
company representatives. Include in your notes the name of the person with whom
you speak, as well as the date and time of the conversation. Ask for the
person's phone extension so you can contact them directly the next time you
call. Listen carefully and make note of the answers given to you by that
person.
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| Stay calm and be positive. It will make the
process go more smoothly and could result in a more beneficial outcome on your
behalf. |
Be Persistent
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| Keep in mind that a simple error might have
caused your claim to be denied. The hospital or the billing staff at your
doctor’s office might have entered an incorrect code when your claim was filed
with the insurance carrier. Or your claim might have inadvertently been sent to
the wrong insurance company. This type of error can usually be cleared up
quickly with a single phone call. |
| If, after your initial conversation with the
company, it is still refusing to pay a claim, be persistent. While most
insurers pay claims presented to them in a timely manner and in accordance with
the wording in their policies, a few carriers might initially delay or deny the
payment of a claim. If this occurs, be sure to obtain the claim denial in
writing. You might need to make several calls to the company before it pays the
claim. |
What to Do if an Insurance Carrier Continues to Deny Your Claim
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| Contact the Alabama Department of Insurance for
assistance. Generally, you must first submit a letter to the insurance company
requesting that your claim be reconsidered, giving specific reasons why you
believe your claim should be paid. When composing your letter, be as detailed
as possible explaining why your procedure or medication is necessary and should
be paid for under your insurance policy. Request all evidence (medical records,
x-rays, lab results, etc.) available in support of your claim and send it to
the insurance company with your appeal letter. Be sure to keep a copy of
everything you send to the insurance company for your records. In response to
your letter, your insurance company will indicate the next steps in the
process, as well as the time frame for any additional follow-up or appeals.
They may also request additional information from you and/or your medical
providers. |
More Information
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You can contact the Alabama Department of Insurance online at
www.aldoi.gov, or by telephone at 334-269-3550.
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| Travel Insurance Can Protect Your Vacation Investment |
| 5/15/2008 |
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What Is Travel Insurance?
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| Travel insurance can protect against the loss of
non-refundable travel costs, such as airfare, hotel and tour expenses. Other
types of travel insurance offer protection against losses due to medical
emergencies, damage to personal property, and even a death which may occur away
from home on vacation. |
| Before you buying travel insurance, check the
refund policies on prepaid expenses. Some will refund your money if you cancel
months in advance, but few will offer any refund if you cancel at the last
minute. |
| If you’re working with a travel agent you trust,
ask about his or her experiences with any recommended travel insurance
companies. Have their customers filed claims? Were those claims paid? If you’re
planning an adventurous vacation (i.e. skydiving, scuba diving), ask if the
insurance will cover those activities. |
What Is and Isn’t Covered?
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| Travel insurance policies aren’t all the same. If
you buy travel insurance, be sure to review the policy, especially the list of
covered reasons for canceling your trip. For example, a travel insurance policy
may not reimburse you if you decide not to make a trip because a conference was
canceled.
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| Before purchasing a travel insurance policy, ask
about pre-existing conditions and age limits. Some policies cover pre-existing
conditions if you buy the coverage within a week or two of booking your trip.
Others won’t pay for pre-existing conditions or charge a higher premium to
cover them. Some insurers charge more for older travelers. |
| Cruise and tour operators may offer Cancellation
Waivers. Keep in mind that waivers aren’t insurance policies and aren’t
regulated. Read all of the restrictions before you buy a Cancellation Waiver. |
| Before you buy travel insurance, review the
policies you have now. If you have life, health or homeowners insurance, you
may not need to buy certain types of travel insurance. Read your policy and
speak with your insurance company or agent to learn what personal property and
medical coverage you have while you’re traveling. Also, ask what insurance
benefits you may have if you use a credit card to pay for the trip. |
| No policy can guarantee your safety when you’re
traveling, but knowing you’re covered for medical emergencies or the loss of
personal property may help you relax and enjoy your vacation.
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Major Types of Travel Insurance
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Trip Cancellation/Delay/Interruption Insurance
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Trip Cancellation – Reimburses you for pre-paid travel expenses if you aren’t
able to take your trip because you or a family member becomes ill or dies.
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Travel Delay – Reimburses you for pre-paid expenses if you aren’t able to take
your trip because of a travel delay, such as a flight delay or cancellation.
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Trip Interruption – Reimburses you for pre-paid expenses if your trip is cut
short because you, or a family member, become ill or die, or because of any
other misfortune listed in policy. Covered reasons might include bad weather,
airline strikes, terrorism, bankruptcy, jury duty, or fire or flood damage to
your home.
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Medical/Accidental Death Insurance
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Medical/Health – Reimburses you for medical and emergency dental expenses that
you have because of an illness or injury while you’re traveling.
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Medical Evacuation – Provides emergency transportation to take you either to a
hospital in the geographic region where you are or for transportation back to a
hospital near your home.
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Accidental Death – This coverage is usually split into three parts:
1. Air Flight Accident – Covers death or dismemberment
during flight only.
2. Common Carrier – Covers death or dismemberment
while traveling on public transportation such as a plane, ferry, train, bus or
taxi.
3. Accidental Death – Covers death or dismemberment at
any time during a trip.
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Baggage/Rental Car Damage Insurance
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Baggage Loss – Reimburses you for lost, stolen or damaged personal items. This
usually doesn’t cover personal items that may be lost or damaged by an airline.
If you buy baggage insurance be sure to review the policy for the list of
property that wouldn’t be covered. Some of your property may exceed the limits
allowed.
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Rental Car Damage – Reimburses you for damage or loss to a rental vehicle. If
you have this coverage you may decline the “collision damage waiver” rental car
companies offer. This coverage doesn’t provide liability protection.
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| Earthquakes Not a Covered Event by Standard Homeowners’ Insurance Policy |
| 4/21/2008 |
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“People think of earthquakes as a California-only concern,”
Commissioner Bell said. “The reality is that the New Madrid Fault, which could
affect northern parts of our state, can generate serious earthquakes."
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| “No standard insurance policy, including the
homeowner's policy, covers catastrophic damage that is caused by an earthquake.
For an additional premium, companies offer an earthquake endorsement with your
homeowner's policy that will protect you in case your home suffers earthquake
damage. This coverage is typically inexpensive and should be considered.” |
| Approximately 20 earthquakes have occurred in the
Midwestern U.S. beginning Friday, on which an earthquake that was 5.4 on the
Richter scale struck. |
| “If you have concerns regarding earthquake
coverage, I advise you to contact your insurance agent to inquire about an
earthquake endorsement if you live in an area where an earthquake is possible
to occur,” Commissioner Bell said. “If you have any questions beyond that,
please contact the Alabama Department of Insurance.” |
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The Department’s website is www.aldoi.gov.
The toll-free number to the Department is 800-433-3966.
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