Call Collett: Authorized repair, claim denied by insurance company

Claim Denied_488438

As a loyal customer for 30 years, a local homeowner expected the insurance company to pay his claim when his air conditioner broke.  He got pre-authorization for the fix, but the claim was later denied.

After fighting the company for months, he called Count on 2 Investigator Rebecca Collett.

“The temperature was going up and up,” Via explained at his Hanahan home.  “It was getting into the mid 90’s.”

When the air conditioner broke in August, Sears initially approved the repair.  They reimbursed the Vias the $500 they paid up front for the service.  After the initial service, the air conditioner still wasn’t running right.

“It was just warm air coming out,” he explained.

Sears sent the Vias a second approval form for more work to be performed.  With the addition of a little Freon, the system was finally cooling.  When David submitted that second claim, he expected to be reimbursed.

“They said it would not be covered because it hadn’t been authorized,” he told News 2.

He faxed his paperwork several times and even tried a call to customer solutions.  After five months of trying, he was frustrated.

“Obviously I can’t get to the right people. Maybe you can,” he told Rebecca Collett at his home.

Following News 2’s contact with Sears, we were told customer solutions would look into the issue.

One day later, the Vias got an email.

“I wasn’t even sure to open it because I thought it was some sort of scam,” he told News 2 during our follow-up interview with him

Sears told him they would reimburse his money after all.

According to a company spokesperson,  some sort of administrative error was to blame for the denial.

A spokesperson sent News 2 the following statement:

“At Sears, our top priority is the satisfaction of our members. Our member services team reviewed Mr. David Via’s situation and has issued him a check to cover the second claim ($299). We regret the delay, which was caused by an administrative error, and hope Mr. Via remains a loyal Sears customer and Shop Your Way member.”

In the end the Vias are thankful for their money back, but they want to send a caution to others.

“Do not let them push you around if you really feel like they owe you something,” he said.

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