I have previously mentioned that Richard always believed in being over-insured. His work offered a supplemental accidental death and dismembership insurance for just a few dollars a month. Just a few months before the accident was the open enrollment time. Richard was very stressed during that time and although he was going to increase the insurance (which was the first time it was raised above what we already had), he didn't get to it. Still, we had pretty good coverage.
I contacted them when Richard was still in ICU to let them know that we were going to qualify for getting payment on this insurance. they wrote me everytime I wrote to them to tell me why we did not qualify for payment. After we got the diagnosis on Richard's eye (before the second eye was diagnosed), I wrote to them again because eyes are specifically covered. At various times in the process we thought his foot might be covered, or his arm. Anything that is considered a "member" is covered if it is lost. The problem with the foot and arm were that although they did not work and probably never would, they were still attached. They had to be removed in order to qualify. Fortunately for us, that was not the case with the eye. He could still have an eye, as long as it didn't work, it was covered.
Our insurance was through AIG. I wrote to them requesting the proper forms to ask for payout and they sent me paperwork. Then I would sent it back and they would say that they needed another form. I would sent that form in and then they would say that they needed somthing else. This went on for months. Finally, I wrote to them telling them that I felt that they were playing games and that if there were more things that they needed, I wanted a list of ALL of them. They sent me a list. I sent an envelope with all the remaining documentation with signature confirmation. I received the confirmation back and then they said that they had never received it. I said that legally, they had received it. I had proof that they received it. They wanted me to sent it again. I sent it again, and I sent it with signature confirmation again. When I got the second postcard back, the signature was EXACTLY the same as the first one. By this time I was in Wyoming (which tells you how long after the accident we are talking about, probably close to two years!) Again they said that they had not received it. I told them that I was no longer at home and I didn't have access to all of the documentation, but I did have some of the documents on my computer. I emailed those to the woman that I talked to. Of course, she told me that I didn't send her everything she needed so they were not going to pay. I went on line, at that point, to the New Mexico Insurance Commission. I filed a complaint against AIG for refusing to pay when they had received documentation three times! Within 24 hours, our check was in the mail.
I am convinced that the insurance companies are hoping that you give up in the fight with them to get the claim paid. The amount was too large for me to give up, but I still was frustrated that I had to get the insurance commission involved before they would pay. Interestingly enough, AIG declared bankruptcy during this time and within a month or so before we receive our check, the government had to bail them out. I am not generally in favor of the government bailing out companies, but I was pretty desperate so I was REALLY glad that they government bailed out AIG.
Within the next six months after our original payout, Richard was reading the policy and realized that we were actually entitled to more money than we had received. They played the same game for that payment than they paid for the first one. Fortunately, I had the experience so I contacted the insurance commission much earlier in the process. Then later, we found that we qualified for additonal money under another provision. I said that it wasn't worth it to me to have to fight them again. Danielle said that she would do it for me, and of course at that point, they paid immediately.
The lesson to be learned is that you have to be persistance with insurance companies. You also have the option to contact the state insurance commision if they are being complete jerks, which they sure were in our case. I could go on a major rant about insurance companies here but I am going to refrain. Just know that I don't think too much of them. I think they are a necessary evil.
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