Insurance – it is something you pay for every month, or every paycheck, and it is supposed to be there when you need it.  What happens when it seems that the system is working against you more than for you?

There are hundreds of insurance companies, each with hundreds of plans available.  They use coded phrases, words and numbers to make their processes easier for them, but more confusing for you.  It can be hard to find one person to speak with regarding your claim among the various voice-mail directories and the army of individuals in various departments in major insurance companies. 

Yet, insurance companies are regulated by each state.  Every state government monitors the actions of insurance companies and how they work with us, the consumer.  These agencies are your advocate in making sure insurance companies deal with you fairly. 

When an insurance company does not cover your medical expenses according to the contract that you have with them, they are guilty of fraud. 

If an insurance company is reported a certain number of times in a year to their state board, they will be put up for an inspection by the state regulating agency.  Insurance companies do not like to be inspected, and they tend to put whoever is complaining on the “quick pay” list…just to get you out of their hair. 

To file a complaint in Tennessee, you can go to this link:

http://www.tn.gov/commerce/insurance/complaint.shtml

In Georgia, go to this link:

http://www.gainsurance.org/Fraud/Home.aspx

I have had to report insurance companies in Georgia in the past, and I did get paid as a result.  You do not have to allow them to use their large employee base, coded mail messages, and confusing processes to keep you from getting back the money you are due.