How to Give Outstandingly Bad Customer Service in Health Insurance

Health Insurance Does Not Insure HealthImage by SavaTheAggie via FlickrOne of the things I love about blogging is that I can speak my mind about a number of things. Most of the time, this happens to be about people being dweebs on gaming forums and saying silly things while MMO servers are down, or about adventures we have trying to kill bosses in dungeons, or about Geek Funk. These are usually fun and/or just plain silly.  Occasionally, Serious Things happen in my life, and I feel compelled to share them with you.  Face-palming at this atrocious behavior somehow makes us all feel a little better.

So, today, Trusty Friends, the discussion is “How to Give Outstandingly Bad Customer Service in Health Insurance.”  The company in question? Well, I don’t want to say the name of the company…oh, who’s kidding who? Of course I’m dying to tell you it’s Wheaton Franciscan! 

Now, this is the company Trusty Hubby has been working at for years.  However, he’s been deployed to Army active duty several times during his tenure at this particular hospital. When he’s on active duty, we are covered under the military’s health insurance, so we don’t use Wheaton Franciscan’s health insurance then.  To be fair, we’ve never had any problems until he returned from this latest deployment.  Apparently, Wheaton Franciscan hired a number of new Vice Presidents during his last deployment who feel the need to justify their salaries by making life an unbearable hell for the rest of Wheaton Franciscan employees.  This includes cutting benefits, cutting jobs, cutting salaries, and just plain denying coverage for anyone trying to get back on the health care plan.

Now, since Trusty Hubby has been employed at WF for a number of years, and despite the fact that the insurance plan has covered us in the past without any problems, and has all of our information on file, we found out we had to jump through some new hoops to get coverage again when Hubby went back to work after coming off of active duty.  Apparently during the time he was gone, WF had discovered all sorts of people claiming family members who weren’t really family members.  “Hundreds”, we were told. There are only a few hundred WF employees–am I somehow supposed to believe that a good 75% of the employee base was committing insurance fraud? Give me a break.

So, then we needed:
a. Birth certificates for our kids
b. Our marriage license
c. Social security numbers for everyone (what they did with this information they already had on file, I don’t know–it’s probably being spammed out to identity thieves in China, Russia, and/or Algeria).
d. A copy of our 1040 tax form proving that all of us were claimed on Trusty Hubby’s tax form so that WF would believe we had kids. If they show up on a tax form, then of course they exist!
e. Proof from my workplace that I didn’t have insurance through them, or we’d have to pay a surcharge
f. Providing detailed information on an online form.

We dutifully sent all of this in. Once. Via Fax.  When we asked several weeks later what the status was, did they have any of the paperwork? Of course not.  We faxed it again.  Silly us, this should have been our first clue that things were not going to turn out well, and that things should have been sent certified mail.  We called again.  Naturally, it was ‘not received’ again.  Of course, their viewpoint is, ‘if our fax machine doesn’t spit it out for us, you never sent it’.  I suspect they intentionally avoid putting paper in the fax machine so they a. don’t have to do work that day, and/or b. have plausible deniability when someone calls to ask if they’re now covered.  I was informed that I also had to fill out the online form again, because ‘something was wrong with how your husband filled it out’. I jumped through that hoop for them, too.

So, let’s sum up so far:

We’ve sent in the paperwork 3 times, and finally hand-delivered it once.
We’ve filled out the online form twice.
I’ve faxed in the form showing I don’t have coverage through my employer twice.

Everything should be set, right? 


What we have:
Coverage for Trusty Hubby.
Coverage for our son.
No coverage for our daughter.
No coverage for me.

That’s 50% wrong, my Trusty Friends.  I’d like to point out that if I got things 50% wrong in my office, 100% of my patients would be half blind.  Thank God these people aren’t in charge of anything Really Important, like the CDC labs or nuclear ballistic missiles. We’d have radioactive Ebola viruses spread over half the world.

What we’re paying:
Family coverage, for employee, spouse, and all kids.
A surcharge for me, because, surprise, surprise, they LOST the paperwork sent TWICE stating I have no coverage through my employer. So, they’re taking extra money out of Trusty Hubby’s pay, all while not covering me, because this is a brilliant financial move according to some VP in the company.

What I call this: Fraud. Pure, unadulterated FRAUD.  We are paying for something we are not receiving.

Last week, we received an email from them, stating they could not cover me until we sent them another copy of our marriage license.  Apparently, the copy we picked up from the county courthouse, actually got signed by the Chaplain, witnesses, and everything ON THE DAY OF OUR WEDDING, was not good enough.  Despite the fact that it’s been good enough for the US Army for the last 20-odd years, it is not good enough for WF.  No, WF required the version with serial numbers on it, notarized, licked, sealed, and containing both my bra size and the DNA of the County Clerk in triplicate on it.  They don’t want blood, however, because that would be a biohazard.

At this point, after having dealt with this for months, and seeing this ridiculous new requirement designed to delay coverage even LONGER, I decided that contacting the State Board of Insurance would be a simply excellent idea. I told the state that I thought this was a delay tactic so that the company would either not have to cover the 2 most expensive people in the family or could delay paying our claims.  Not so coincidentally,  the two of us who are not covered are the two who’ve actually seen a doctor in the last 3 months. I’d do my best Gilbert Gottfried impression and say “What as surprise! I think I’ll have a heart attack and die from that surprise!”  However, I’m not sure what my insurance status is, so having a heart attack right now is out of the question.

Contacting the state turned out to be an even better decision when I received a letter from the insurance company the next morning, DATED JUNE 1, stating they needed copies of all our paperwork, YET AGAIN, and that it was due–get this–MAY 30TH.

Now I was really mad.  When I call to make a complaint, I am polite, but firm. You catch more flies with honey than vinegar, no matter how big the fly is. Nevertheless, I informed them that sending me a form dated 2 days AFTER the due date was about as intelligent as hitting an electrical line with a metal pickax, and that we had sent PDF copies of everything JUST THE NIGHT BEFORE.  The lady who spoke to me was amazingly patient, and informed me that everything was OK, explained that yes, I still had to jump through the idiotic marriage license hoop because the one we have isn’t ‘official’ enough for them, and that we’d have until June 20th to get this in, as a special grace period.

Today, I received a letter saying my spouse coverage was terminated as of March 31st. The lady I spoke to on the phone again today reassured me we had until June 20th to get the paperwork in.

Sure. Like I believe that after all this BS.  I’m sure the State Board will find all of this fraudulent activity about as fascinating as I do. Moral of the story–if you have insurance problems of any kind, contact your State Board of Insurance. They can help you get it resolved.

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