Filing Insurance Claims for the Uninformed and Forgetful....

I know that most people don't have a desire to understand insurance. I really didn't either before I took the job and realized that people just buy things and have no clue what they're getting or what's covered. It only leaves them open to becoming angry and freaked out when they realize that something wasn't covered and they were expecting a $10k check in the mail.

I wrote this to offer a few helpful hints when people are attempting to fill out a claim form. Chances are---unless you work or have worked in insurance before---you probably won't find the complete humor in it. But it is meant to be funny as well as informative.

Here you go:


I can't believe the lack of common sense people have these days. It's disheartening and sad. I realize that the topic of insurance is one that makes people zone out and fall asleep but if you pay for benefits and you expect to get paid of you have something happen---you should at least take the time and energy to f***ing understand what you're buying. It just makes sense!!!

I need to teach a class on how to file a claim. Lesson 1:

1. Sorry but, creating your own box to check on the form isn't going to magically grant you a benefit you didn't sign up for. If there wasn't a box for it on the original form---there shouldn't be one after you fill it out. And no, you can't just DECLARE that you had a service done---you must show a bill as proof!!

2. If the service you had done was not mentioned (included or excluded) anywhere in your insurance paperwork---it probably isn't covered. Please don't freak out on us when you find out you won't be paid to have your tits lifted and your ass vaccuumed out. Just because your doctor is crooked enough to call it "medically necessary" doesn't mean it's covered or that we will pay you for it.

3. There is such a thing as including too much with a claim form. Please don't send the pictures your doctor took during your colonoscopy. His notes and bill are sufficient. We don't need to see the polyps in your ass to pay you for them.

4. When faxing your paperwork in:

a. Please don't fax me all 300 pages of your complete medical history 9 times. Fax once---then call to see if all pages were received. In faxing over and over---you have successfully shut my office down by clogging up my fax machine for 3 hours as well as blazing through 7 reems of paper.

b. Only send what is pertinent to the claim you're filing! I don't need to read about every yeast infection and genital wart you've had when you're only filing for a wellness benefit.

5. You cannot file a claim for an accident we have already paid you for. That should be self-explanatory but apparently needs to be said again.

6. You cannot file a claim for an accident that occured 15 years before you bought your policy. You may still feel the effects of the buckshot in your big fat ass but unless you had this policy in your chubby little hand when you got shot---you probably aren't getting paid when the bullets finally make their way out. Also note that if you were doing anything illegal (including being under the influence of drugs or alcohol) when you got shot---any benefits would be denied.

7. Please refrain from getting insanely angry because you decided to drag your feet in buying the policy and then had an accident before it was in effect. It is not our fault you can't take 5 minutes to sign your paperwork in a timely manner.

8. Please also refrain from losing your mind when your policy lapses because you didn't pay your bill. We send you a statement every month. It's not that hard to open your mail. We also offer automatic draft in the case that you're too stupid to write a check.

9. If your policy states that it will pay a certain benefit once a year---that's it. Just because your creepy doctor said you needed 15 Pap Smears this year doesn't mean we're going to pay for all of them. And I suggest you get a new doctor because this one has issues.....



I think that's more than enough to take in at one time. I realize that people are idiots but I hope that these little tips might help during enrollment season. Help me help you!!!


Love,

Your Friendly yet Frustrated Office Administrator