Tuesday, April 20, 2010

Overboard! Tales From A Claims Department

I haven't blogged too often about my "previous life" as a nine to five employee but every once in a while, something will remind me of a funny situation or story that happened while I was an office worker.

Here's one of them.

One of the jobs I had within the large insurance company I worked for was in the claims department. Part of that job included processing dental claims.

I'll never forget the time I received a claim form requesting reimbursement for a set of dentures. Some of the questions on the form were left blank so I couldn't process it. Back in the "Stone Age", we used to have contact with claimants so I picked up the phone and called "Buddy" for the missing information.

He was very nice but became a bit evasive when I asked why he needed new dentures when he had made a claim for a set only a few months before. His contract had a five-year limit on new chops unless this claim could be processed under the special "Accidental Dental" clause.

So after going back and forth with him and not really getting an answer, I finally got right to the point and asked "Where are the dentures we just paid for?"

Hesitantly he replied, "They're somewhere in Smith's Lake".

Okay, that's the last thing I expected to hear so even though I had the information I needed and told him I couldn't pay the claim, I just had to ask "How in hell did they end up in a lake?"

Being the good sport he was, he told me he had gone on a fishing trip with his buddies, had a little too much to drink, got a little seasick out in the boat and yep, while puking over the side, had those sparkling pearly whites we had just paid for fall right out of his mouth and sink to the bottom of the lake in front of his bloodshot eyes.

And no, I didn't keep a straight face, I laughed into the phone and had a good chuckle which, unfortunately, was at his expense.

Claim denied!

post signature

44 comments:

~J said...

LMFAOOOO!! Poor Buddy! I'm willing to gather you heard loads of good stories while working that job, no?

blueviolet said...

Poor toothless dude was denied!

MiMi said...

I kinda feel sorry for that guy! LOL

Simply Suthern said...

I think the Claims folk still laff every time they get a claim.

I dread calling in.

Gropius said...

No teeth AND claim denied? Oh, what a bad day!

Dual Mom said...

Hahah I wonder if he tried to return the new set because you wouldn't pay for them! Big meanie! lol

That is funny.

Jennifer @ The Toy Box Years said...

Oh, thank you for giving me a much-needed laugh today!!!

But I hate to laugh at poor Buddy's toothless expense!

Mammatalk said...

So, was he talking with a lisp?

What a funny story!

Heather said...

Oh no...lol! Poor guy...lol

Danielle said...

Poor old guy. Looks like there is going to be another toothless old man to add to the world. LOL. Too bad I would've laughed at his expense too!!

Anonymous said...

Sorry for my bad english. Thank you so much for your good post. Your post helped me in my college assignment, If you can provide me more details please email me.

Debbie said...

Ha...my AUnt once accidentley threw hers out the window...apparently they where in a tissue, not thinking, however littering now that I think of it, she tossed it out the window....teeth be gone!~

Respectfully Yours said...

Excellent - thanks for the laugh.

My Aimless Infatuation said...

That was classic.....poor fellow.

Dreamfarm Girl said...

might have been worth paying for a kid to dive for them! gotta feel sorry for him...that bites!

Arizona Mamma said...

Holy crap I wouldn't have been able to refrain from laughing either. Great story.

Buckeroomama said...

Aww, poor Buddy! I wonder how long before he got a new set... or if he tried to retrieve his old set from the lake... ew.

Chocolate Covered Daydreams said...

Poor guy! At least he was honest. Too bad he didn't get a new pair.

Homesick Cajun said...

Girl, this happened to my sister's ex! About five years after they spilt he got dentures. A couple of months after getting them he was on his way home (a friend was driving) he got sick and was puking out of the car window (eww!) and yup! Lost his damn teeth! God...we laughed for days over this one! He was a tool!!

Ian said...

HAHA we have that type of thing all the time. I work in claims...well sorta lol

Still On The Verge said...

Just found you today. I am 36 and in perimenopause. Glad to have found you!

Lydia

Annie said...

that is hilarious! Poor guy :(
I guess men never grow up do they? What is maturity anyways? LMBO

Erin said...

That may very well be one of the better stories I've heard in a while! LMAO!

Mae Rae said...

OMG that is the greatest story...I can totally picture it happening too. Too much beer and water don't mix.

Linda Medrano said...

That's funny but sad too! I mean, shit happens right? He should have said he was mugged and they got stolen!

Aphrodite's Mortal Friend (ME) said...

Really- I started laughing when I first read the word denture ... I've got to let my husband read this one!

Danielle said...

Yep, when dealing with people, there are always some good stories. Some peoples kids!

3LittleMonkeys said...

HAHA...too funny. I also used to work with health and dental claims, and the stuff that we would receive.....I could only imagine what was going on in their lives!

Tiffanee said...

That is really funny! Poor guy you just have to feel for him. Atleast you can say that day at work was not boring.

Anonymous said...

Great information! I’ve been looking for something like this for a while now. Thanks!

Heather said...

Poor fella! The weirdest things do happen, such a shame he couldn't get another set. I think it should be mandatory to get two sets, just incase of the unforseen accident.

At least his story was funny!

Aunt Juicebox said...

At least he was willing to wear dentures. My dad won't, and that's entertainment all by itself.

Anita said...

I wonder where he is nowadays, and if he's stopped drinking, and if he's gotten some more dentures. Hmmm... :)

ModernMom said...

LOL Poor old soul! That drink really cost him!

Pink Haired Momma said...

LMFAO!!!
That is hysterical. OMG! Thank you so much for sharing. I love it when you share moments from your "previous life". They always leave me pissing in my seat!

Carrie said...

That is a great story! Thanks for making me laugh this morning and thanks for the follow!

Blessedmom's Simple Home said...

LOL, we had to pay for a new retainer for the same reason. My son had the flu, forgot to take out his retainer, and after losing his dinner, and flushing, he thought about it, and realized where his retainer went. They told me they'd never heard that one at the orthodontist office before.
Blessings,
Marcia

NYCGAL said...

Literally laughing out loud here! This is so funny!! Thanks for the laugh gf!

gayle said...

oh no! So funny!!

RN Mama said...

Bahaha! I love this:) I so wish I could share some of my stories of patients, I have some good ones!

Pam said...

OH my Gaw! This is the kind of shit that will happen to me if I ever get dentures. I kind of feel bad for him. Ok.....I'm over it.

kanishk said...

I think the Claims folk still laff every time they get a claim.
post free classifieds

Anonymous said...

I really interested in your post. Actually I posted a similar related article in my blog regarding this issue. What is your opinion about it?
http://www.healthgrounds.net

Bill

Anonymous said...

Willingly I accept. In my opinion, it is an interesting question, I will take part in discussion. Together we can come to a right answer. I am assured.