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Re: [IP] can anyone help?

Hey there...  I'm from Wisconsin, and I also happen to be an insurance 
agent here.  My first suggestion would be to gte rid of CRL as soon as 
humanly possible.  They are the WORST insurance carrier I have ever done 
business with...  and by that I mean EVERY aspect of their company.  I'm 
amazed that they are actually in business.  I will see what I can find out 
for you...  As for making a complaint with the insurance commissioner - 
that's a good start.  You should check your state statutes, because they 
are required to respond to a complaint in a timely manner.  I believe in 
Wisconsin it's 45 days or something...  (I'm pretty new at this stuff)

At 04:41 PM 12/12/01 -0800, you wrote:
> > I am at my wits end!  I am from Missouri and I have Central Reserve
> > Life(CRL) as my primary insurance.  I have been on the Disetronic
> > Insulin Pump since 04-1995.  I now am trying to purchase a new
> > D-Tron.  I also have to utilize the Healthlink PPO network.
> > Disetronic is not currently a Healthlink PPO (they are in the middle
> > of contracting) So I have been working with Edgepark Surgical, which
> > has been a horrible expierence!!!  CRL is telling the supplier that
> > they will pay for a purchase of an insulin pump since it has been
> > pre-determined that it is a covered benefit under my policy and that
> > since this is not a rental option they will be paying the purchase
> > price but in 6 monthly installments.  They will take the Healthlink
> > contracted price and break it up into 6 payments to the supplier.
> > Well, guess what, the supplier(edgepark) will not do this because
> > they have had 4 other patients in the past with CRL and it takes CRL
> > 6 months to make the first payment and then they also cannot bill my
> > secondary until the final payment is made.  I am outraged by the
> > purchase price payment over 6 monthly installments.  Also if these
> > payments fall into the next calendar year they will also have to
> > deduct from those payments my calendar year deductible again even
> > though the purchase happened in 2001.  At this point the purchase
> > isn't going to happen because the supplier is regusing to provide
> > this to me and there are no other Healthlink suppliers in this area
> > to provide it to me.  I have talked until I am blue in the face.  I
> > am physically ill over it.  My secondary is changing as of 01-01-02,
> > which adds tons more issues to my problem.  I have talked to
> > numberous people at the insurance company and NO ONE will help me.
> > One manager even flat out told me that they have been treating
> > insulin pump purchases this way for 11+ years in this fashion and
> > they aren't going to change now.  I have also made a complaint to
> > the Dept of Insurance which will take months to hear from and I have
> > spoke with an attorney for advice.  I am stuck between a rock and a
> > hard place.  Even though this is a purchase and CRL has acknowledged
> > that it is a purchase they are going to pay it in monthly(rental)
> > payments. Does anyone have any suggestions or has anyone out there
> > been through this?  You can email me at email @ redacted Thank
> > You Laurie D.
> >
>Check the contract language to see if they are allowed to delay the
>payments. I suspect that this is probably not part of your insurance
>contract and if it delays you receiving treatment would be a
>violation of the agreement. See if you can get some help from the
>insurance specialist at Disetronic, contact the insurance
>commissioners office, etc..... but FIRST read the contract of
>email @ redacted
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