Not covered for something? REFUND ME EVERYTHING!


Long time lurker, here is the story of my worst customer in my 12 years working in call centers.

In my last job, I was working for a major canadian collective dental insurance. For those that might not know how that work; it is an insurance that your employer buy for their employees.

Pros: That kind of insurence is nearly always MUCH better that what an individual can afford, as the insurance compagny can share the risk between all the employees.

Cons: The EMPLOYER choose(usually) what is covered or not.

To the story.

Got a call one day from an older gentleman thay started insulting my compagny, me, god, everybody.
After waiting for a hole in his verbal vomit, I finally managed to talk to him trough security, and asked what the issue is.

Customer: “You did not cover me for my implants(almost 10K$ in fee)

Me: “That is correct sir. Let me put you on hold while I check why.”

Then I look at the Everest of notes in his account

For more then a year, he tried to get paid for those implants.

He first sent a treatment plan.

Refused as implant not covered under your plan.

He then sent a 2nd treatment plan, with additional X-ray.

Refused as implant not covered under your plan.

He then sent a 3rd treatment plan, complete with a written letter from his dentist how those Implant are required for his health issue.

Refused as implant not covered under your plan.

Then he still chose to do those implants, which were refused because, you guessed it!

Implant not covered under your plan.

Going back to the customer, explaining that , no Implants are not coveted, even if it is a necceseray procedure, no you cannot add implant under your coverage, as it is your employers choice to cover that kind of care or not.

C: ” All right. Then refund me EVER-RY-THING ”

Me: ” As I told you, impl… ”

C: * cutting me off * ” No, no, you dont understand. I have been with you for the past ten years, and I never use my dental insurence for anything. The ONE time I try to claim something, you… ” * insert 20 min rant on how all insurance compagnies are crook *

Obviously, we cannot refund everything the customer paid for the last ten year. Not using your insurance is not a valid reason. Customer then said the magic words:

C: ” I WILL go to my lawyers, the better business bureau, the MEDIA if you do not refund me IMMEDIATELY. ”

Me: ” As is it now a legal issue. I am now obliged to end this call. Please direct your lawyers to contact our legal team. Good day. ”

He actually did contact his lawyers. We received an email a few weeks later asking for more information from his lawyer. Our legal team only said o e thi g:

Implant not covered under customer plan.

Blame any and all typos on aliens.


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