***NOTE - we don't have a separate 'claims' department, as such. If someone has a claims enquiry, they call through to our call centre. We either resolve the issue on the spot for them or if need be, send an email through to a claims assessor and they get the matter sorted. They then email us back with the outcome and we call the customer back to let them know it's been resolved.
*** A guy calls in ***
Me - Welcome to Health Insurance Inc, how may I help you?"
Stupid Customer - "Claims"
***silence***
Me - "Oh, um...did you mean you have a claims enquiry?"
Stupid Customer - "Claims"
Me - "Ok. Alright, well...do you have a membership number I can start with?"
Stupid Customer - "No"
Me - "Ok. Was this in relation to a claim of your own?"
Stupid Customer - "Yes"
Me - "Okay. I'll just bring the policy up using your name, could I get your name there please?
Stupid Customer - ***Gives me a females name***
Me - "Oh ok, sorry, you were just saying this is a claim for yourself?"
Stupid Customer - "Yes"
Me - "Ok...but you just gave me the name of someone else"
***silence***
Stupid Customer - "Medical claims"
Me - "OH! Oh, were you calling from a Dr's office?"
Stupid Customer - "Yes"
Me - "Oh ok, oh well that explains why you didn't have their membership number. Ok I'll written that name down, could I just grab the patient's address, date of birth and the item numbers you're chasing up"
Stupid Customer - ***Ignoring everything I just said*** "Yeah so how come you people haven'tpaid my daughter's claim?"
Me - "Your...daughter's claim? OK, just so I can clarify. Who is this claim for?First you said it was yours..then you said you were calling from a Dr's office... I need to verify who I'm speaking with before I can proceed. "
Stupid Customer - "It's my daughter's claim. You people never paid on it. Why."
Me - "Ok, so it's your daughter's claim. Is she on your policy?"
Stupid Customer - "Yes"
Me - "Ok, that's fine, if she is on your policy then I can discuss her claim with you. Now when I brought her name up before it only had her name there. Did she recently transfer to your policy then?"
Stupid Customer - "Yes"
Me - "OK, what was your name, I'll bring her details up that way ***I get his details and search - sure enough, I find his policy, but she is not on it*** Ok, I found your details, but she is not on your policy"
Stupid Customer - "Right"
Me - "Ok but you said she was on your policy"
Stupid Customer - "I have authority"
Me - "There is no authority for anyone on her policy. Did she send us a written letter of authority for you?"
Stupid Customer - "Yes"
Me - "Ok, was that very recent? It might not be loaded on file yet"
Stupid Customer - "Why didn't you pay her claim?"
Me - "I can't discuss anything until I find this letter of authority. Did she mail or fax it?"
Stupid Customer - "She hasn't sent one"
Me - "Ok. You will need to get your daughter to call. Thanks, bye!"
What did he think lying at every question was going to achieve?
What a dumb f**k.
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