Since June, 2019, my wife and I have been engaged in "battles" with several institutions of power and privilege. We have been engaged with the worlds of medicine, pharmacology, hospitals, major medical insurance, and home owners insurance.
We have appreciated this engagement with varying degrees of appreciation and satisfaction.
My wife wisely sorted through options and enrolled us in Medicare prior to moving home to Texas. Medicare is primary and AARP supplements are secondary. Part D covers medications. Her leadership has been a blessing.
Insurance is a huge deal in our world. If you have it, you are blessed, and if you don't, you're in trouble. Some of you have followed my health care journey on this platform or on Facebook. Either one, you've read some rather dramatic things about my health, hospitalizations, and medications. Those have at time been frightening, painful, and costly.
As an aside before going further, I believe that all of this is about justice. In our society, I think it is wrong for some to have everything covered and for others to live without insurance or to die without insurance and the medical care that it covers. A young man I met several months back told me about the story of his father, a pastor without insurance suffering from the deadly condition of diabetes, and now he is going blind. That grieves my soul, very, very deeply.
There are many structures in our world. Structures are insulated and have rules for their existence. Those structures of power and privilege are inhabited by people who sustain that power and who decide who benefits from the structure.
I have had the best of medicare care from my physicians here in my home town to my medical care team with University of Texas Southwestern. I have had the best of the provision of medicines from the Refill Center affiliated with the Chickasaw Nation, Walgreens, and the pharmacy at the hospital in Dallas. I have had the best of care inside hospitals affiliated with UT Southwestern and here in my hometown as well.
I have had the best of medical insurance. Putting those packages together, my wife and I have paid $0.00 for prescriptions. My cancer meds are very expensive, and that zeroes out. What my insurance companies don't cover, a grant from UTSW covers. A monthly supply is zeroed out. I owe nothing on very, very expensive drugs.
I am clearly a person of privilege in the medical, hospital, pharmaceutical, and major medical insurance worlds. I did not "earn" that privilege but am the beneficiary of that privilege by nature of a chain of events and a conglomeration of events. I do not take that privilege for granted.
On the other hand, my wife and I have been engaged with another monolitic entity, home owners insurance purchased from State Farm. We have had State Farm insurance for years, as far back as we can remember. We do the bundle thing where everything is covered from home to automobiles.
It has become clear to us that my wife and I have no "privilege" with State Farm. Despite the fact that we are long time customers of State Farm, we are indeed secondary to the monolithic system called State Farm insurance. It has also become clear in dealing with our assigned State Farm adjuster that State Farm is his "customer" and we are not.
Back in August, we awakened to a river of water that inundated our kitchen, breakfast area, most of our living room, hallway, utility room, pantry, two bedrooms, one bathroom, and one closet. It flowed beaneath some fairly expensive kitchen cabinets, utitility room cabinets, and bathroom cabinets. It destroyed priceless comic books, which insurance did cover partially.
The company that dried the floors came immediately, set up over the course of nine days 39 heaters and blowers that eventually dried it out. The adjuster said that many were not necessary, despite the fact the he is not the expert on that, but the young man who did the work is the expert. Thus, he approved only 1/2 of that company's charges. This began an intolerable process three or four days after the deluge.
When it was time to hire a "pack out" company, the State Farm adjuster brought in his own preferred provider, and we brought in two providers who had been highly recommended to us. One was a low bid and one that was a high bid. State Farm's? It was low but it set the bar for what the adjuster would approve. The label for that guy, a guy our team had met before? The title was "the Walmart of packers." I saw the manipulation from the start. Let the manipulation and low-balling begin.
The adjuster argued with the company that packed us out despite telling him to go ahead and pack us out. We're here in January, and the pack out will be completed today. The leaders of th pack out company saw how the adjuster was treating us and actually came onsite a time or two to level the playing field.
The adjuster for State Farm did a "quick and dirty" review of the damage, minimal at best, three days after the deluge occurred. Once we saw how the State Farm adjuster was operating, we hired our own public adjuster to represent us and to attempt to mediate the differences. When the public adjuster and the State Farm adjuster finally met at our house, approximately four months after this nonsense started, mediation began and the State Farm adjuster actually spent more time then than he did at the beginning of the process.
You may wonder what was the need for a public adjuster? It was simple. The State Farm adjuster was willing to cover 1/2 of the charges that were to be incurred. We saw how hard they worked and the measures they took to take care of our belongings. State Farm's payment early on was 1/2 of the reasonable charges of the water mitigation and the pack-out, and ultimately the same would be for the renovation.
By this time we were weary of the low-balling of the State Farm adjuster and hired our own public adjuster. The difference between our adjuster's estimate and that of State Farm was enormous.
Eventually things began to thaw a bit. We don't know exactly why. Was it because we hired a competent public adjuster? Was it because Charla challenged the State Farm adjuster and his low-balling, disrespectful, demeaning/sexist treatment of her? Was it because our State Farm agent contacted him on our behalf? Was it because of the scathing letter from my oncologist who nailed him for his treating me/us that made treatment for cancer even more complicated?
We are now in our second temporary house. Curious that State Farm did not release sufficient funds to fix our house, but they will pay a ton of money for temporary housing and storage of our belongings. Figure that one out.
I've researched State Farm and its reputation for these sorts of things, and its reputation is quite sketchy. It is known as the company who pays the least after the longest period of time. I think the company's philosophy is wear them out and then they'll settle.
That said, it is clear that the State Farm adjuster has one customer. It is not us. It is the entity of power and privilege, State Farm, the very wealthy insurance company.
At the end of day, I am proud of the way my wife has handled all of this nonsense. I regret being in a position that I had to take care of my cancer treatment and was nothing more than a back channel supporter for her.
We followed the rules based on the game plan lined out by State Farm. State Farm failed us at the adjuster level. They failed us at the cover our expenses of renovating the house level. Despite what our coverage says, the State Farm adjuster has a rationale that is going to try to put something in but not equal to what we have now.
We are now going to arbitration because our public adjuster and the State Farm adjuster do not agree. The arbitration process may or may not work. I'm not optimistic.
The State Farm property claim process should be easier. A public adjuster should not have to be hired if the State Farm guy does his job. In this case, he failed miserably.
State Farm is reputedly one of the best in the nation; however, one set of evaluations says otherwise. On a 5.0 scale, the rating was overall performance was 3.8. The rating made by users was lower. It was a 3.1. AM Best rates it at a A++. My wife and I will undoubtedly fall in the lower ratings by users.
Bottom line, what are our complaints? What have we found that is unjust in terms of their treatment of long term loyal customers?
1) Incompetent State Farm adjuster;
2) Failure of the State Farm adjuster to evaluate the house quickly and thoroughly;
3) Failure of the State Farm adjuster to collaborate with entities we hired (water, pack-outs, renovation);
4) Failure of State Farm to move swiftly in getting the Hinsons back in their home;
5) Failure to negotiate in good faith such that we hired the public adjuster to represent us and our interests;
6) Failure of the State Farm adjuster and the system to negotiate in good faith such that we now have to hire arbritators; and
6) Failure of the State Farm adjuster to honor the insurance policy.
There may be more.
I am tagging two offices of state farm.
1.) For payments:
State Farm Insurance Companies
Insurance Support Center -- East
P.O. Box 588002
North Metro, GA 30029
2.) Headquarters:
State Farm Insurance Headquarters
Bloomington, IL
3.) Claims
800-SF-CLAIM (800-732-5246)
The irony is that we were treated fairly and justly in the narrative of the first few paragraphs by the medical community and insurance. As I near the end of cancer treatment, we are deeply grateful for the medical care that I received and the ease with which providers were paid.
In the later few paragraphs, we, apparently are in the same boat as a lot of people across Americak. We are being treated unfairly. I think the shenanigans by State Farm's employee hampered my cancer treatment. Apparently so does my medical team.
No comments:
Post a Comment