I worked at “Scam Home Warranty” in the authorizations department a few years ago. I determine if a repair is or isn’t covered and have 16 pages of contract to pull denials. During the “heat” of summer (our busy season) some customers would try and strong-arm us with threats about all number of things, this is one of those stories.
Karen calls in with a customer’s own tech on the line, I’m still pretty new and iI’ts June so call hold times are like an hour.
K – “He’s going to tell you what’s wrong with it and you’re going to give him an auth code or whatever so he can fix it, you understand?”
Me – “I need to speak to the technician.”
K – “He’s on speaker.”
I’m getting the basic info and Karen of course keeps interrupting “why do you need to know that” “why do you care how old it is.” Somehow manage to get enough information on the form that I can cut to the chase but the tech is being pretty vague about whats actually wrong with the unit.
Tech – “so its got a clog in the line”
Me – “Ok so you’re going to blow it with nitrogen?”
Tech – “Well no, its not that.”
Me – “What, its not the condensate line? The lineset with the freon is clogged?”
Tech – “Well its like the condensate line but its not…pumping”
Me – “What pump are you talking about? That’s a drain line, why would there be a pump in it? Is this a water source heat pump or a swamp cooler?” (both things we don’t cover)
Karen – “Listen what you’re doing right now? That’s called badgering, and its a crime.”
Me – (barely concealed smile) “A federal, state or local crime?”
Karen – “You little shit, you are gonna do your job and cover this claim or you are gonna LOSE BIG”
Me – “I need to speak with the tech about this pump.”
Tech – “it’s the recirculating pump, I got one on the truck I just need the auth to fix it today………” (tech gives me part number, labor, service call fee, miscellaneous charges this is overall a very expensive repair about $1500 total)
Me – (checks with my boss while tech is doing this) “OK so this is a geothermal heat pump?”
Karen – “Yep! Top of the line.”
Me – “excellent, let me finish up here and get you over to someone who can help you from here…”
Karen – “Wh-” (call transferred by agent to customer service as we do not cover geothermal heat pumps and the only reason the customer was able to get the claim placed was by lying to the agent about it being a normal heat pump – they could handle the denial from there while I wrote it up in big bold letters Denied Claim: Scam Home Warranty Does Not Cover Geothermal Heat Pumps)
If you or someone you know has a home warranty and you wanna talk about it or something, let me know I’m happy to help you in any way I can. We denied 70% of claims, they can afford to cover one claim once in a while.
submitted by /u/themadkingnqueen