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Complaint 0 of 0 in "Errors in Claim Payments"

Insurance Carrier: Blue Cross Blue Shield
State: Illinois

Consumer Complaint:

I was given wrong information from the BCBS customer representative, and now I'm out $500. I called to verify if a claim would be reimbursable to me, I was told it was 100%. Now after the fact, they tell me since I paid for it directly a $500 deductible applies, but had the doctor billed them directly, they would have paid it in full. Since I was given wrong info from their customer service rep, should they honor what the rep told me? I have appealed my claim and am still waiting to hear.


Insurance Expert Answer:

As these can be "he said, she said" situations you did the right thing by appealing. If necessary you could also write a polite letter to the CEO of the insurance company.