So I own an IT consulting business and have a 10,000 sq ft office which has been largely empty since the middle of March when we went fully virtual.
At the beginning of November the air conditioner in my server room died. As the temperature in the room shot above 95F, the servers all shut down due to the heat.
A quick visit by the HVAC guy led to a $15,000 estimate for a replacement. Given that no one is there, I’ve been leaving the door open and blowing air into the room with a fan.
Fast forward to last week, I received an updated insurance policy because one of our clients required an additional coverage we didn’t have. It was only $50 to add and they sent me the updated policy. I was reviewing it and noticed that our policy included Equipment Breakdown. A call to my broker, a few emails to the adjuster, and magically I am getting a new AC for just our $1000 deductible!
So read your policies to see what coverage you are actually paying for is the lesson learned here.
Relevant here in FL and other humid parts of the USA is also read your policy about what it doesn’t include.
Around here HVAC failures in summer / wet season quickly turn to massive mold infestations. In my condo building we have many seasonal residents who lock their place in March, head North, and come back in Nov expecting all to be well. They are supposed to have a neighbor or paid service check on their place weekly. Some do, some don’t.
After an HVAC failure, in a week the entire walls and ceilings will be gray. In 3 weeks they’ll be black. As will all the contents of the unit. All mold.
It’s well over $100K to gut and rebuild an apartment after that. More like $150K if your tastes in appliances and cabinets and flooring are above Home Depot level. Your homeowner’s insurance covers mold damage typically up to a maximum of $10K, sometimes only $5K. Sucks to be you.
I get to help one of our owners learn this lesson at least twice a year. Each and every year. Sad.
around here the typical lease requires the renter to buy and maintain termite coverage. That is, pay for regular treatments. The cost of doing business here. It turns out that termite damage is also the renter’s responsibility. Makes sense since the renter is paying for the prevention, but Ouch.
A few weeks ago a friend of mine was thrown from her horse. (She was wearing her helmet, thank goodness! It was cracked in places) She was life-flighted to the nearest trauma center, about 40 miles from her house. She had air-ambulance coverage with her health insurance, but it didn’t cover the company that provided the service.
She just got a bill for $58,000. She’s fighting with her insurance company now - they said she need pre-approval, she said she was unconscious and it was a TBI.
What state? I thought that state laws require insurance companies cover emergency procedures regardless of network. For precisely this reason. Perhaps I am wrong or perhaps this doesn’t happen in all states.
I hope your friend has a good attorney. AIUI, insurance companies don’t have to pay for life flights, and many at least initially deny coverage, hoping the patient won’t pursue the matter (though how anyone can give up and pay $58,000 is beyond me).
There SHOULD be a law requiring insurance companies to pay for life flights. I’m not looking for one anytime soon, though.
There are no federal laws governing this, so it’s down to state law. Here’s a guide:
I had a situation like this with a large emergency treatment bill from out of state. I found trying to find an attorney to advise me completely useless. I guess because there’s no money in this for attorneys. The best help I ended up getting was from the office in my state government that oversees insurance and implements regulation.
A while back, hubs felt “funny” and went to his doctor. Long story short, he ended up having a quad bypass a couple of days later. We thought he had good insurance, but ended up with over 30 grand in “out of network” expenses from all sorts of people/labs that were not only not local, but out of state.
Our solution was to write 10 dollar checks to each provider and mail them in every month. After about a year of proving that we were willing to do what we could to pay the bills, I called each provider and asked if they could lower the bill while reminding them that we had mailed them a physical check every month and would continue to do so until the debt was paid.
Most of them just wrote it off because they didn’t want to deal with the expense of dealing with small checks.
State balance billing laws don’t, as far as I understand it, apply to helicopter transportation. The reason why is really stupid: Medical helicopter companies are legally organized as airlines, and under the Airline Deregulation Act of 1978, states cannot regulate the fares charged by airlines.
I think it might depend on the implementation of the laws. Some states prohibit balance billing explicitly, the law is directed at the provider, and maybe that’s caught up in airline regulation as you suggest. But in my state, and some others, there are “hold harmless” laws. These make life much easier, because you don’t have to deal with providers at all, and you don’t have to worry about differences in other states. The law is an obligation on my insurer, which says if I require emergency out-of-network treatment, it’s down to my insurer to negotiate payments in any way it sees fit, and that it’s entirely their problem - they must “hold me harmless” from being pursued by providers for payment, I pay only what I’d pay if I were in-network. I had emergency helicopter transport in a different state, and there was no suggestion that this fell outside the “hold harmless” provision, once I had figured out the law. My insurers were such scumbags throughout the whole process, that I’m sure they would have tried to get out of the helicopter charge if they were legally allowed to.
My wife’s old house had a water line break under a cement slab floor. She checked with her insurance company and was surprised to find it was covered. Instead of cutting the slab under the living room to patch the break, the insurance company paid to have the house completely replumbed.
Folks here may have noted that Congress finally addressed this issue. As always, it isn’t as good as it should be, but it is a significant improvement. The individual is being removed from the dispute. The patient only pays what the current insurance company requires. Out of network charges are to be handled through direct negotiations between the insurer and the supplier. There will be a dispute resolution mechanism but no one thinks it will be used much. Air ambulances are covered. Ground ambulances managed to get themselves excluded from the bill. Yet another reason to take an Uber.