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Dad asked in Education & ReferenceTeaching · 1 decade ago

Why is American Fidelity Assurance Company using stall tactics while processing my claim? Is this typical?

I have heard that this is typical from a lot of people. They sell a lot of policies to teachers and teachers don't make a lot to begin with. Salary protection made sense until it had to be used and I couldn't get them to budge.

Update:

What does credit have to do with it? I have been paying premiums for more than a year.

Update 2:

All that has been done. The agent was called and the letters mailed.

Update 3:

In fact, the last round of 5 letters allegedly mailed missed four recipients in the same city. I received mine and the doctors received 0. We live in the same town and all were dated and mailed on the same day. This has been ongoing for three months. They will get something they requested and then it becomes another, then another, then another. It doesn't seem like there is a lot of compitence or professionalism there.

3 Answers

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  • 1 decade ago
    Favorite Answer

    There are some companies that do this; sad but true.

    I checked out American Fidelity, it looks like they are rated A+ by AM Best for the last 25 years; this is a rating that is based both on financial strength and on service ability.

    Some companies, however, outsource portions of their claims handling; I would look into this. Is there a third party involved, and if so, can you speak to a supervisor there? Did you buy the coverage through an agent, or was it a "program" that was sold through your district?

    If you're working through an agent or broker, call them immediately and get ahold of whoever's in charge of this program. Be nice at first and allow them to resolve it; at this time of year, agencies and brokerages are swamped with January 1st renewals. Service personnel and underwriters are pretty much living at their offices, and will probably be lucky (this week and next) to know which end is up. However, no reputable agency or broker is going to let something like an unresponsive company make problems for a client; give them the info, let them know (nicely, but firmly) how urgent this is, and give them a few days to take care of it. Trust me, being nice to your agent this week will do wonders for how quickly they'll get to your file. It's better than good tips to the pizza guy.

    If you didn't purchase this through an agent, find out who is in charge of this program at American Fidelity and become their "new best friend". Call them every 30 minutes throughout the day if you have to...fax them, email them, call them. Everyone involved - supervisors, assistants, down to the receptionist. Don't let them go until they give you a definite plan of action with dates, times, people they will/have spoken to, and when this will be resolved. Your agent/broker, you want to be nice to; the company, you want to bug the heck out of them until they resolve the issue to get you off their back.

    (If it really comes down to it...ask them who their E&O coverage is through, and how you can report a claim. E&O is short for Errors and Omissions, which is like malpractice for professions like insurance. If you state it as "E&O", they will be more likely to realize that you're ready to play hardball and they'll do what they can to make you happy. I don't normally encourage this, but if you can't get a response any other way - and please try every other way first - this should do it. It's a harsh thing to do - it's like threatening a malpractice suit with your doctor - but if they really are being negligent, it shouldn't come as too much of a surprise.)

    I'm sorry this is happening; it's likely that yours is the file that fell through the cracks, and the problems just keep getting bigger. The only way to resolve it quickly is to either make sure someone you trust is on it, or get on it to the point they'll do anything to make you stop.

    Source(s): 10 years in the insurance industry - both claims handling and brokerage. I was fondly nicknamed "the bulldog"...but I got what my customers needed out of the companies, and my customers knew it.
  • 1 decade ago

    Each company is different, but you may want to check your policy, is there a waiting period (most pay check insurance has one). Also in most cases they have to go through all the med records first... if this is the case they may be waiting for the dr to get the records to them, in this case you can call the dr and ask them to hurry them along, the dr will respond to you much better than an insurance co. in most cases. If you had an actual agent come out and sell it to you see if you can get a hold of the agent for some assistance. Good luck.

  • 1 decade ago

    well it depends on how your credit is if you got good or bad credit it can really effect alot of stuff like that you might wanna take some background info on yourself bout your credit and all that to see if thtas the reason

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