Tagged: military insurance
The Military Family Association has published a resource page for servicemembers and family members affected by the tragic tornado disaster that befell the community of Moore, Oklahoma on Monday.
The tornado struck near Tinker Air Force Base. A number of Air Force families may have been severely affected and/or rendered homeless. Base personnel who need immediate assistance with food, clothing or emergency financial assistance can contact the Tinker Family Readiness Center at 405-739-2747, 405-736-3813, or 405-736-3847.
You can also call these numbers to volunteer. The Family Readiness Center is in the process of organizing work and relief teams to go out and assist Air Force personnel and their families in need. Alternatively, you can register as a volunteer at this link.
If you’re an Air Force member affected by the storm, visit AFPAAS and fill out a needs assessment. This will inform the Air Force that you’re accounted for and alert them to any supports or services you or your family may need.
USAA Field Assistance Teams
If you have insurance from USAA, you can contact one of two emergency assistance teams already on site at these locations.
First Baptist Church of Moore
301 NE 27th St. (I-35 and NE 27th)?Moore, OK 73160?Hours: 7 a.m. to 7 p.m. Everyday ?Services: Claims
501 SW 19th St.?Moore, OK 73160?Hours: 3 p.m. – 7 p.m. Today ?7 a.m. – 7 p.m. Thursday and everyday until further notice.?Services: Claims
Members can report claims by using USAA’s Mobile App on their iPad, Android and/or iPhone smartphones, online at usaa.com/help, or by calling 1-800-531-USAA (8722).
Emergency Prescription Refills
If you are a TRICARE beneficiary and you need an emergency refill of your prescription (because, for example, your home was destroyed), take your prescription bottle, if you have it, to any TRICARE retail network pharmacy. To find a network pharmacy near you, click here. Alternatively, you can call Express Scripts at 1-877-363-1303.
These procedures apply to the counties for which the Governor of Oklahoma has declared a state of emergency. As of this writing, those counties are Cleveland, Lincoln, McClain, Oklahoma, Pottawatomie. Emergency refill procedures are in place for TRICARE beneficiaries through June 17.
If you lost your military ID, you’ll need to get it replaced at the nearest DEERS enrollment office. If you lost your TRICARE enrollment card, call TRICARE customer service 800-444-5445.
More information is available from the State of Oklahoma here.
USAA has expanded its outreach to the storm-ravaged areas of the Northeastern United States. The number of field offices assisting members with claims and other financial services has been increased from two to five offices.
The original two offices in Vienna, Virginia serving the DC area and in Atlantic City are still in operation. In addition, the company has established four new offices.
The new USAA field assistance offices have been established at these addresses:
Here is a list of USAA’s field offices as of 4:27pm, 2 November 2012:
- BMW of Atlantic City. 2037 Black Horse Pike, Egg Harbor Township, New Jersey
- Kennedy Restaurant, 406 Bayside, Breezy Point, New York
- U.S. Coast Guard Station, 85 Port Terminal Blvd, Slip 6, Bayonne, New Jersey
- Traynor Collision Centers, 901 Bridgeport Avenue, Milford, Connecticut
- Embassy Suites, Tyson’s Corner, 8517 Leesburg Pike, Vienna, Virginia
Locations and hours are potentially subject to change. You can, however, get the latest locations by typing the text command LOC to MYUSAA.
We contacted USAA to ask what they were doing to assist members. USAA spokesperson Rebecca Hirsh informed us that USAA was ready to help members in storm-affected areas in the following ways:
- Discounts on auto loans
- Discounts on credit card rates and personal credit lines
- Forgiveness on late fees and finance charges in some circumstances
- Possible increased credit lines on credit cards and personal lines
- Discounts on car rentals via Hertz and Avis
USAA declined to give specifics over the phone, but instead urged members affected by the storm to call for assistance. For flood insurance questions, however, call 1-800-427-4661 or contact your insurance company or agent.
Streamlining Claims Processing
USAA also made it possible for members to initiate the claims process online, or even via mobile applications available at the USAA Web site. Applications are available for the iPhone, iPad, Android and Windows 7 Phone.
600 Adjustors, USAA Customer Service Workers Descend on Storm Area
According to the USAA spokesperson, the company now has some 600 workers on the ground in the storm-affected areas – mostly adjustors. The assistance centers are also staffed with employees who can help members initiate a damage claim on site, or do even more mundane things like initiate a checking account or arrange for replacement checks or credit/debit cards to be sent.
Check Your Text Messages and Emails
USAA has already emailed tens of thousands of members in the area with specifics on what programs they may qualify for to help get them through the aftermath of Hurricane Sandy. For more information, contact USAA at www.usaa.com or call them at 800-531-8722.
USAA announced that it has set up two emergency field offices to settle homeowners, auto and rental insurance claims military policy holders incurred as a result of Hurricane Sandy. The two offices are near Atlantic City, New Jersey and the District of Columbia.
USAA claims adjustors are on site and ready to examine property damage.
Here are the specifics locations, contact phone numbers and hours of operation.
Tysons Corner Collision
8550 Tyco Road
Vienna, VA 22182
7 a.m.-7 p.m. everyday
Services: Claims Assistance
BMW of Atlantic City
6037 Black Horse Pike
Egg Harbor Township, NJ 08234
2 p.m.-7 p.m. on Thurs.
7 a.m.-7 p.m. everyday
Services: Claims Assistance
Locations and hours are potentially subject to change. You can, however, get the latest locations by typing the text command “LOC” to MYUSAA.
For flood insurance questions, call 1-800-427-4661 or contact your insurance company or agent.
As of this writing, the devastating floodwaters of Hurricane Sandy that devastated the Northeast are receding and recovery crews are getting to work restoring access, emergency services and power to the afflicted areas. And millions of people are now getting back to their homes, sorting through what’s left, and picking up the pieces.
This article was written primarily in response to Sandy, but the principles are always the same:
1.) Go over your homeowners or renters insurance policy. Ideally, you should have this document and other key items stored off site, well away from your home. Assuming that you have Internet access as you read this, though, you can frequently read your policy particulars online by going through your email archives to when you bought or last modified the policy. Understand that standalone homeowners’ insurance policies don’t usually cover floods. Flood coverage happens under a separate policy, administered by FEMA. If you didn’t bother getting flood coverage, then you can make the repairs out the money you saved not paying those premiums all these years.
2.) Update your contact information with your insurance company. This is critical if you had to relocate or find temporary lodging pending the repairs to your home. It’s also important if you gave the insurance company a landline number, rather than a cell number. Update your contact information with a number you can actually be reached at. If you miss an appointment with an adjustor, it will just take you that much longer to get your payout.
3.) Photograph and document the damage. Hopefully, you also took an inventory of your property prior to the storm – and stored that inventory off site. This inventory will be invaluable in winning any disputes with an insurance adjuster. Yes, USAA is a fine company. But they are not pushovers when it comes to paying claims. One reason their rates are affordable is because they don’t give away the store to everyone with a stubbed toe who presents a claim for indemnification.
Tip: Don’t neglect outdoor property, to include the value of your landscaping, valuable plants and trees, outdoor lighting and recreational items.
Include any food spoilage that might have occurred, too. How much meat did you have to throw away after it thawed? How much would it cost you to replace all the dairy items and produce you lost because your refrigerator was out for a week or more?
4.) Take steps to mitigate further damage. Remember, as a policy holder, you have a duty to mitigate the insurance company’s loss. If you are a USAA customer, you are also part owner in the company. The obligation goes double for you, and for any others insured via a mutual company – that is, an insurance company owned by policyholders and not stockholders. Board up windows if you need to. Put up tarps and other coverings to prevent further water damage to wood, insulation and drywall. If you fail to take these reasonable and obvious steps to prevent further damage to your home, the insurance company may well reduce your compensation or contest your claim. This could cause a delay in settlement. The insurance company’s claims adjusters are alert to signs of negligence.
5.) Keep your receipts. If you have to buy materials or labor to make temporary repairs to mitigate your loss, have those receipts handy for the claims adjuster. Insurance companies generally want to encourage responsible, proactive behavior on the part of policyholders to limit damage. You shouldn’t normally have trouble getting reimbursed for these expenditures, over and above your deductible.
6.) Journal the process. Keep a record of every conversation with your insurance agents, your insurance carriers, and any adjustors.
7.) Don’t delay. File your claim with your insurance company as soon as possible. That way, the evidence of storm damage is fresh and there hasn’t been time for additional damage to occur from follow-on rains, exposure, etc. That makes it more difficult for an insurer to counter your claim with an accusation that you failed to mitigate damage.
When the adjustor comes
It might take a while. There are millions of homes affected and only so many trained insurance adjusters to go around. It’s important to be prepared when the adjuster comes to visit though.
Have your own consultant there for the inspection. It can be difficult to make schedules work: Independent adjustors, contractors and the insurance company’s own adjustors are all working overtime trying to process claims as quickly as possible – and they are all incredibly busy in the aftermath of a storm or other major disaster. The ideal, however, is to have a qualified, experienced contractor or independent adjustor present for the insurance company’s adjustor’s inspection. If you can, have some estimates in hand to mitigate the damage.
Show all structural damage. It’s critical to be sure the adjuster sees all the damage in all areas of the home. Not all damage is readily visible. The home may have suffered severe foundational damage, for example, profound wet rot damage in areas not obvious to the casual observer. Inspect your home thoroughly before the insurance adjuster arrives, so you will be able to identify anything the adjuster might have missed before he leaves.
Document all upgrades and improvements you made to the property. Did you just put in a new hardwood floor that’s now ruined, when all the other homes in the area have shag carpet and concrete floors? It will cost you extra to replace that hardwood. Did you have a kitchen remodel done? Is the ruined bed made of solid wood rather than particle board? Make sure the adjustor knows the special features and marks of quality and workmanship of every damaged item. It isn’t bragging. You paid premiums to ensure you are made whole on any loss, minus your deductible, up to the limits of the insurance policy. It’s to your advantage to get as close to the policy limit as you can – provided you are honest and truthful in your representations.
After the Adjustor Comes
In most cases, you’ll get your money very quickly. Your check from the insurance company should cover the cost of replacement or repair, up to the dollar limit of your policy, minus your deductible. Note: Some states are now requiring insurance companies to waive the deductible, in the aftermath of Hurricane Sandy. This is true in New Jersey, Maryland, Connecticut and New York so far.
Brace yourselves: If you’re a military retiree or retiree dependent/family member, your TRICARE enrollment fee will be going up, effective tomorrow, October 1. The amount of the hike depends on when you enrolled. The new fee will be $269.28 per year for individual enrollees, and $538.56 per year for families. For those of you who were enrolled prior to October 1st of 2011, your 2011 fees were $230 and $460, respectively.
If you enrolled after that date, your current fee is slightly larger than those who enrolled prior to October 1, 2011.
Even so, TRICARE rates are bargain-basement, compared to private sector plans offering benefits anywhere near comparable – even where civilian employers are paying half your premium. On a monthly basis, TRICARE Prime costs $22.44 per month for individuals, and precisely twice that for families.
Exception: If you are a survivor of a deceased servicemember, or if you have been medically retired, your fees will not be going up. You are exempted from fee hikes, as long as you are continuously enrolled in TRICARE Prime.
Alleged Wrongful Denial of Medical Coverage in Auto Accident Claims
If you are a USAA Auto Insurance customer – or you were hit by one – and USAA denied coverage of medical expenses arising from an auto accident, an Oregon law firm would like to have a word with you.
The law firm of Gatti, Gatti, Maier, Sayer, Thayer, Smith and Associates, out of Salem, Oregon, has announced that it is pursuing a class action lawsuit against the United Servicemembers Auto Association (USAA), alleging the wrongful denial of legitimate claims to cover the cost of medical care following auto accidents involving USAA auto insurance customers.
Specifically, the plaintiff firm accuses USAA of “breach of contract and the breach of the duty of good faith and fair dealing to its insureds.”
At issue is USAA’s relationship with a third party firm hired to review case files of claimants. The suit alleges that file reviewers at Auto Injury Solutions (AIS), which was hired to help USAA control or reduce fraudulent claims, were “routinely” denying reasonable and necessary care, as determined by usual and customary practice and the recommendations of medical personnel.
The suit claims that these file reviewers made their decisions based on “bogus” criteria and “authorities which are not appropriate to the individualized injuries.”
The complaint cites a number of cases from actual plantiffs. In one case, Brittney Bathurst, a 17-year-old daughter of a retired military veteran, was severely injured when her car was t-boned by another car travelling at high speed. Emergency responders had to use the “jaws of life” to extract her from her ruined vehicle, and transport her to the hospital.
Ms. Bathurst’s mother, who owned a USAA policy, filed a claim. However, according to the complaint, USAA sent Bathurst’s medical claim file to an AIS file reviewer, who rejected the claim as not medically necessary. The case file contained a note saying a physician’s review had been completed. But the file reviewer was Leslie Kancir, an acupuncturist in Lakewood, Colorado.
The Gatti Law Firm is seeking plaintiffs with similar stories to tell, as well as evidence and testimony supporting the allegations against USAA.
The case follows a similar class action case, Horton vs. USAA, an Arizona case which was concluded last year. It is too late to join this case. Another similar case was concluded in Illinois in the mid-2000s.
For its part, USAA’s position is that the use of third-party case reviewers such as Auto Injury Solutions is a vital safeguard against insurance fraud. They also assert that preventing fraud is certainly in the interests of their policyholders and association as a whole. USAA believes that the use of third-party case reviewers assists them in validating billing data and preventing overcharging – allowing them to keep rates at affordable levels, which benefits all USAA members.
USAA is a mutual association, jointly owned by members. As such, any savings or profits that USAA realizes accrues ultimately to the benefit of plan members, rather than stockholders on Wall Street. As a mutual association, USAA does not have the obvious conflict of interest between owners and customers, because in mutual insurance associations, the customers are ultimately the company owners.
However, even mutually owned insurance organizations are bound by the terms of their contracts. The Gatti Law Firm is alleging that when USAA, acting on the recommendations and findings of their AIS vendor, denied or reduced claims based on flawed or irrelevant data or guidelines, that they were acting in violation of their contracts with their insureds.
The Gatti Law Firm specializes in insurance litigation, including bad faith and class action lawsuits against insurance companies. Daniel Gatti, the lead plaintiff attorney, told a San Antonio daily that USAA was once one of the most honorable insurers in the country – but was now focusing on cost containment, at the expense of our military. USAA countered by pointing out that they had paid out more than $1.3 billion to USAA members in dividends in 2010 – practically all of whom were military, veterans or family members of military members.If you are a USAA member, and you believe you may have been wrongly denied a medical claim as a result of a covered auto accident – or if you are not a USAA member, but you were involved in an accident with a USAA customer, and your claim was wrongly denied, contact the Gatti Law Firm.