Claim# 306949 from NHP. On 07/09/08 I contacted NHP regarding my air conditioner not getting cold and was given the information to contact Inner Air. I contacted Inner Air (Scott)who inspected and told me that it would cost $1675 to repair the unit or that for $1820 I could get a new unit. I agreed to pay the difference($145) and stated that I wanted the new unit. Scott informed me that he could do the work the next day (07/16/08). He installed the new unit. I called NHP on 07/17/08 and faxed the information on my new unit so that my warranty could be updated and was told that the claim would not be paid because there was no authorization requested. Ii then contacted Scott/Inner Air with this information. He stated that I should not have sent any paperwork to NHP and that I should never have told them that the repair had been completed. I inquired why authorization was not requested. I have been receiving many threatening phone calls from Scott regarding this claim. I feel that I completed my obligation by filing a claim and it is not my responsibility to oversee the contractor with following procedures to have his work authorized. It is the contractor's responsibility to take the necessary measures to get paid. Scott stated that am suppose to pay him and get reimbursed from NHP. I, too am employed in a profession where ai have to request authorizations for services prior to visits to the pediatric clinic. It is not the policy holder's responsible for getting authorization, that is a contract between the carrier and the provider of services. I know that claims are processed and paid by the insurance carrier and an explaination statement is sent to the policy holder stating the amount that they are obligated to pay if any. I do not feel that I should be penalized for the negelnce of Inner Air. I assume that Inner Air has providing services to other policy holders and can only wonder, how many other policy holders have treated this way. We as policy holders depend on the carrier and the contractors that they are affiliated with to have our best interest in mind. Please assist me in clearing up this issue as Scott is continuing to make threats. This is very disturbing to me as a faithful policy holder with NHP to be treated in this manner. Again, i stress that it is not my place to do the leg work for the provider of service to make sure the he is paid.
You may contact me via email at [email protected], phone 408-281-9923 home or 408-621-6677 cell.

Thanks for your immediate attention in resolving this issue.

Carolyn Elmore-Martin