Question:
How is it LEGAL that my Insurance Company won't talk to me?

How is it that I am not permitted to speak to the department that is handling the decision whether or not to approve my surgery?! I PAY these people! Doesn't that mean THEY work for ME?! How is this even legal? (Naturally, I did not express anger or frustration when talking to them today. It's early enough in the ballgame that I don't want to step on any toes yet.)    — Karen P. (posted on January 15, 2003)

January 15, 2003
Hi Karen. I can completly empathize with you! I, too, have Cigna (but mine is PPO, if that makes any difference, which I doubt) and have the worse time getting a straight answer from them. I have found that each department works out of a different office (actually a different state) and I don't believe the right hand knows what the left hand is doing. I hope that you have better luck with dealing with them than I do. I actually said those words to them, but it didn't get me anywhere, however she managed to give a little attitude rather than information. Good Luck.
   — Regina S.

January 15, 2003
Hi Karen, boy girl do i know what you mean. I also have Cigna PPO and getting past customer service is near impossible. I called one night right before they closed and was lucky enough to reach a nurse. She was absolutely wonderful. She gave me a fax number that i could use to get across the the medical review board. She also tried to put me through to one of them but they qwere already gone. A couple of days ago I called again and actually got a very warm and compassionate lady by the name of Diane. She was going to walk herself to medical review and get my records and have her boss do the approval and I will know no later than this Monday, so I guess you just need to keep calling till you find that one person who's willing to go up and beyond the call of duty..God Bless Karen, and may you have good luck
   — Michelle L.

January 15, 2003
Karen: I asked an insurance question a while back, similar to yours. Here is how one poster answered me. "Write a letter to the President of Claim Operations of BCBS (or your ins co) in your area. Explain to him/her that you have tried to get a response. Let them know you are fighting mad and tired of their stall tactics and you want an answer within 30 days or you're sending a letter of complaint to your local Insurance Commissioner. Send the letter to the Director/President by certified mail...then you have proof of them receiving the letter. Also, call ahead and ask the person's name you need to send it to. If that doesn't work, go to your personnel manager at work and ask for the name and phone # of your insurance rep and call them too." The person who wrote this works in the insurance industry. If it's still fairly early in the game, maybe you should hold off for a while to avoid "ticking" them off. You didn't say how long you've been waiting for an answer. I hope this helps and good luck. The insurance part of this is so frustrating!
   — Carlita

January 17, 2003
It can't be legal! because I don't pay for ins.(M/A) and in the beinning process I would call my ins. co. sometimes 2 times a day and talk to the same person or someone in another department, with no problems, when I was inquiring about wls, up until I was approved. My ins. co. has a customer service department, yours should too. I even spoke to the lady who reviews the referrals several times to make sure she had all the paper work. I will say this again, they would normally speak to you when you enroll. Good Luck!!
   — JUNE P.

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