Undeniable Claim

This week my focus is on insurance. Weird, I know, but I hope you will understand my need for this coverage. (pun intended)

Undeniable Claim



In October my son was involved in a playground accident that sent us rushing to the ER for stitches.

The school provided us with a completed form to submit any out-of-pocket expenses to their insurance. I dutifully photocopied  our bills and carefully checked and double checked all the information. Within two weeks I received a letter that our claim had been processed. Woohoo! (That was in December.)

The first week of January I received a bill for the October ER visit. This was stressful. I just knew I was going to have a fight on my hands with the insurance and/or hospital.

After a quick review of the claim notification from December, I found the column outlining the exact amount of the bill. It was marked “Amount Denied.” Dang it! How could I have missed that?

I called the number on the claim notification and spoke immediately to a customer service rep. She was polite and explained that the $87.02 was the discount amount agreed upon by the hospital and their company. She did not know why I received a bill but would put me through to their company’s adjuster Jennifer.

Jennifer was unable to take my call at that time so I left her a detailed message.

Adjuster Jennifer called back the next day confused about my question. She said I had nothing to worry about unless I received a bill. I explained that I did receive a bill and was really hoping she could help me. Jennifer told me to email a copy of the bill to her and she would call the hospital. I figured it would be a week or so and I would have to call back. 😦

The next morning I received an email from Jennifer. She explained that the hospital would not honor the agreed upon discount. This made me very sad. Her message went on to explain that she would adjust the claim so that we were covered by their company. This made me happy.

I called Jennifer to thank her and we spoke briefly about how hard it is to have active children. She shared, that because of the horror stories she encounters with her job, she wouldn’t even let her son play sports until he was 14. I can only imagine the claims she has to deal with!

The service she provided us was so quick and compassionate. It was one of those moments that puts faith back into the human race. Thank you, Jennifer!

If you find yourself in a position of uncertainty, do not let anger or angst fuel your search for resolution. Remember there is another person on the other end of that phone call or email. My hope for you is that you receive the same speedy and kind response that I did in this situation.

If you are in a position to provide customer service, do not let the constant demands of your clients wear you down. Keep the human spirit alive and well in the responses and services you provide.

Whether we are the client or the provider, our Intentergy should be aimed at finding solutions together. Patience, communication, and politeness are key to accomplishing our goals.

Humankind – Be Both.

By: Melanie A. Peters

P.S. I am glad I had this insurance, but I really don’t want to have to use it anymore. 🙂





4 thoughts on “Undeniable Claim

  1. Nicely done and fabulous outcome with customer service person Jennifer….I will now counter your glass half full with my glass half empty. Yesterday I had a puncture and found the supplied repair resins were defunct…my service people despatched a nice chap who fixed the hole and arranged a mobile service to come to my home to replace the tyre today…I duly call to find out where they are to be told they had left a the text message, voice mail and email saying it had been deferred to Monday because their chap was ill. Alas for customer service person I had said devices at hand to point out someone was fibbing because not a single ond of those alleged calls or notifications had arrived and were it not for me calling them I’d be sitting around for a no show having taken time out to wait for their service chap. Not to mention if person is poorly, does that really collapse your ability to run the business? Confidence lost on the basis I prefer truthful feedback rather than overt fabrication, said service was cancelled and I will sort it out myself tomorrow.

    Had I read your post first then I would have recommended they seek advice on customer services from Jennifer 😜

    I much prefer your tale to mind !!!!

    Liked by 1 person

    1. Gary, that stinks! I wish I could fix the whole situation for you. Keep your chin up. Thank you for sharing and your support. You reassure me all the time that there is good in people with the posts and comments.

      Liked by 1 person

      1. Just a bit…but there are more good people than bad ones in my opinion so I never let it bother me too long. Besides by this time tomorrow it should be sorted 😊 I hope alls well with you

        Liked by 1 person

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