Insurance and honesty dilemma

**Daisygirl** · 11-22-2009, 02:19 PM

Back to the basement saga! I am putting together the insurance claim for the damage to my basement and the things that were down there. In a way, this has been a gift from God, because the insurance money will give me a few more months of running my business without needing a part=time job to supplement. Because of this I am striving to be as honest as humanly possible when filling out the endless paperwork. Nearly everyone I know is telling me to "take them for all you can" but I am going to get enough just being completely honest.

My dilemma is this. I just got a copy of the paperwork from the heating and airconditioning company that cleaned out my appliances and checked them out. The guy told me when he was here that I needed a pump for my air conditioner, which I never had previously. He told me "Don't worry, I won't charge you for it." I thought he was just being nice. It will definitely make my ac work more efficiently next summer. Imagine my surprise when I saw he had charged the insurance company for "Replacement of Damaged Pump". The charge was over $400.

I feel really guilty, like I am ripping off the insurance company. I have to sign the paper, agreeing the work was done. If I don't sign it, then I will get charged for the work. If I do sign it, I am saying it is true. I can't afford that pump. I figure the guy really was trying to be nice, and if I say something he could lose his job.

You may think I am silly but I just feel very dishonest. Would you just brush it off and sign the papers or would you call the insurance company and report the heat/ac guy?

**suebeehoney** · 11-22-2009, 02:29 PM

Karen -

I applaud you for your honesty in this situation. There are many who would do just what your friends have suggested - "take them for all you can".

Myself, in that situation....I would be as honest as possible. It's been my experience that any dishonesty only comes back to bite you in the backside later. Sometimes it seems that honesty does the same thing, but at least you can sleep at night!!

I'd rather be an honest person, be a little poorer or less well-off than a dishonest person, and be able to sleep at night and live with myself...than a dishonest person who gains everything but at the cost of their own peace of mind and the respect of others.

**nuisance26** · 11-22-2009, 02:37 PM

~It does look dishonest and I think you need to be sure of all the facts before you signed the papers.
Are you sure that the pump wasn't needed because of the damage? Sometimes things that used to work fine need an additional boost after damage. "Replacement of damaged pump" might be the only insurance code for that claim despite the fact that nothing was "replaced".
Call the AC company to clarify why exactly you needed the item.
Then call your insurance company and explain the situation. There may be insurance fraud going on here(the AC company)and I'm sure you wouldn't want to get wrapped up in it.~

**Greebo** · 11-22-2009, 03:49 PM

Originally Posted by Daisygirl

because the insurance money will give me a few more months of running my business without needing a part=time job to supplement.

Um...

I know, not the main topic...but...

Is the business losing money? Or just not making enough?

**shoiji** · 11-22-2009, 04:06 PM

Call the company and tell them you need to speak with a supervisor at the company. If the part has not been put on I do not see how you would need to pay for something you do not want put on. Explain the part was not put on and you do not intend to sign-off on paperwork that says it has been.

If the company pressures you I would call the insurance company and let them know what is going on. You can also call the better business bureau.

Keep a record of all the calls for your files. Hope everything gets straightened out.

Check the energyboomer website. He used to be on frugal village. He is a wealth of information concerning heating and a/c. He will also answer questions. I get his weekly updates which are free to receive. Might be a source to find out if you really need the part. Or if it could wait until you could afford it yourself. It is winter now and you probably don't need your ac until summer.

Good luck.

**Daisygirl** · 11-22-2009, 04:18 PM

The part was put on, I saw it, but it was not there previously. It is a helpful part but not absolutely required for the operation of the air conditioner. The ac guy put it on to be helpful because now I do not have a hose running across my floor into the drain hole, it is pumped up into the waste water. I am sorry, I must not have explained that clearly.

So my dilemma is: keep the part and keep my mouth shut and be happy to have it, or rat the ac guy out ( who I think was trying to do me a favor) and wreak havoc on his life, as well as delay my insurance claim.

Greebo, in answer to your question, the business is brand new, and it is not making enough to support the girls and me yet. It is paying for itself but not yet paying me. (heehee - a different thread in which I will whine later). If I have to get a part time job to support us, then I am cutting the hours of the shop, which means I am not giving enough time to the business. After replacing that which requires replacement, I will have some money leftover to keep us afloat until (absolutely and undoubtedly) the business is able to pay me.

**monkeywrangler71** · 11-22-2009, 04:36 PM

Instead of calling the insurance company and getting everyone in trouble, start by calling the AC company and telling them you aren't comfortable with lying. Maybe they'll come take it back, or maybe your previous setup with the hoses was no longer possible or was adding to the drainage problem and it really did need to be replaced. In which case, they weren't replacing a broken pump but rather using a pump to replace a broken system.

Either way, start with the AC company and give them a chance to fix/explain the situation before you report them.

**Luckybustert** · 11-22-2009, 07:18 PM

I agree with monkeywrangler71, especially since the AC guy may have just been trying to help you out. Helping him out by giving him a chance to avoid any trouble on his end seems like a nice way to return the favor.

**frugalwarrior2** · 11-22-2009, 07:45 PM

A dishonest favor is not a favor. He has made you uncomfortable w/ his actions. Call the a/c company and speak w/ someone. If it cannot be resolved w/ them,make a notation on the ins. co. paper then sign. It may come off the money the ins. co. gives you back but you'll feel better and teach your children to live honesty not just talk it.

**mombottoo** · 11-23-2009, 09:49 AM

Originally Posted by Daisygirl

...My dilemma is this. I just got a copy of the paperwork from the heating and airconditioning company that cleaned out my appliances and checked them out. The guy told me when he was here that I needed a pump for my air conditioner, which I never had previously. He told me "Don't worry, I won't charge you for it." I thought he was just being nice. It will definitely make my ac work more efficiently next summer. Imagine my surprise when I saw he had charged the insurance company for "Replacement of Damaged Pump". The charge was over $400.

I feel really guilty, like I am ripping off the insurance company. I have to sign the paper, agreeing the work was done. If I don't sign it, then I will get charged for the work. If I do sign it, I am saying it is true. I can't afford that pump. I figure the guy really was trying to be nice, and if I say something he could lose his job.....

He was being nice...to you. He did exactly what he told you he was going to do...he put the pump on and he didn't charge you for it, he charged your insurance company. Nobody gives away a $400 part to be nice and if I were in your situation I would have known that he was intending to charge the insurance company. The time to have told him "no, thank you" would have been before he installed the part. Sounds to me like you are feeling guilty after the fact...call the AC company tell them the pump was put on by mistake and ask them to either remove it and adjust the bill or make arrangements to pay them out of your own pocket for the pump.

**Daisygirl** · 11-23-2009, 10:03 AM

Originally Posted by mombottoo

Sounds to me like you are feeling guilty after the fact....

Hmmmm..... no, not really. I had no idea the part was going to be anywhere near that price, never having dealt with heating and ac before.

**Nishu** · 11-23-2009, 01:27 PM

Originally Posted by mombottoo

He was being nice...to you. He did exactly what he told you he was going to do...he put the pump on and he didn't charge you for it, he charged your insurance company. Nobody gives away a $400 part to be nice and if I were in your situation I would have known that he was intending to charge the insurance company. The time to have told him "no, thank you" would have been before he installed the part. Sounds to me like you are feeling guilty after the fact...call the AC company tell them the pump was put on by mistake and ask them to either remove it and adjust the bill or make arrangements to pay them out of your own pocket for the pump.

This was clearly a case of the repairman being dishonest. Most people don't even think twice about things like this and probably wouldn't even look too closely at the receipt. They probably do this thing on a regular basis and get away with it just due to the ignorance of the customer. Even a cynical person like myself would think that most people would sooner do without an unnecessary piece rather than commit insurance fraud.

This was not her fault.

This guy was doing himself a favor, as nice as he might have been, I doubt he had Daisygirl's best interests in mind.

I'd call up the company and tell them to come get it and remove the charge from the insurance. BUT BE CAREFUL HOW YOU MAKE THIS CALL. You need to (as politely as you can) make it clear to them that they knew they were committing insurance fraud and that you did not realize what they intended to do. If you just call up and say that it was put in mistakenly, they might try to tell you that you'll have to pay for the pump if your insurance company doesn't.

They knew what they were doing. Hopefully you won't have to put the heat on them in order to uninstall it and take it back without charging you, but I'd have the number to the insurance company handy just in case.

**mombottoo** · 11-23-2009, 03:26 PM

Originally Posted by Nishu

This was clearly a case of the repairman being dishonest. Most people don't even think twice about things like this and probably wouldn't even look too closely at the receipt. They probably do this thing on a regular basis and get away with it just due to the ignorance of the customer. Even a cynical person like myself would think that most people would sooner do without an unnecessary piece rather than commit insurance fraud.

This was not her fault.

This guy was doing himself a favor, as nice as he might have been, I doubt he had Daisygirl's best interests in mind.

I'd call up the company and tell them to come get it and remove the charge from the insurance. BUT BE CAREFUL HOW YOU MAKE THIS CALL. You need to (as politely as you can) make it clear to them that they knew they were committing insurance fraud and that you did not realize what they intended to do. If you just call up and say that it was put in mistakenly, they might try to tell you that you'll have to pay for the pump if your insurance company doesn't.

They knew what they were doing. Hopefully you won't have to put the heat on them in order to uninstall it and take it back without charging you, but I'd have the number to the insurance company handy just in case.

Didn't say it was her fault...said I would have known. Every time I have had a claim I get an estimate...the estimate lists what work is going to be done. Not sure if it's the case here, some insurance companies don't require an estimate before the work is done. But, she did authorize (by not telling him no thank you) the ac guy to put the part on knowing full well it wasn't on prior to the claim. By not finding out in advance how the part/labor was going to be paid for she got herself into a pickle.

People do tend to be unscrupulous sometimes when it comes to insurance claims which really bites. Like I said, if it were me I'd ask them to remove the part & rebill the insurance company or I'd take my lumps and pay for the part/labor myself. Never assume that someone is going to suck up the cost of something you need themselves...generally doesn't work that way...especially when insurance is involved. JMHO