Posted on : 30-03-2010 | By : Frank Eliason | In : Business, Customer Service
Last week while I was in Chicago I received a call from my wife regarding an explanation of benefits (EOB) insurance form she received in the mail. This is not something normally discussed over the phone when a spouse is away, but this was a unique experience. The form was not addressed to me as the subscriber, nor was it addressed to her. The subscriber was listed as Gianna R. Eliason, our daughter who passed away in 2004. This was upsetting, especially since we had no clue how they could have had her name. In fact, Gia never even saw a dentist! This policy was effective in 2007, three years after Gia’s passing. Neither of us recalled ever having the insurance company with any prior employer. Here is the EOB (with the name of the insurance company removed, our address and other identifiable information removed):
Needless to say this prompted an immediate phone call to the company by my wife. When she called the agent could not see the paper EOB and had to search for the error that was clearly visible on the EOB in both the mailing address and the header. The representative stressed repeatedly that the claim was paid. Unfortunately, this was not the point! The agent was eventually able to see the EOB and the error. Sadly all she could assure my wife was that the glitch would be reported. Because the representative did not know how the error occurred, she could not guarantee that it would be corrected. I found this unsettling and opted to send an email later that evening. I asked for them to let me know how this type of error could even happen. The next day I received multiple voicemail messages. The first acknowledging this horrid mistake and a promise to get into the details of it. The second was asking me to call back to discuss the findings. I was offered a cell phone and asked to call, even in the evening. I thought that was above and beyond. I called back when my flight landed around 7:00 PM. The nice gentleman promptly answered, knew the details of the case off the top of his head, and was very willing to share the cause of the mistake. He let me know that through 2 prior employers I had coverage with them as they managed the dental portion of my medical plan. The claim queued up for underwriting review, it was processed and approved but the agent somehow selected the incorrect field from a 2002 plan for the 2010 EOB that would be sent to us. He was very professional and apologetic through the short conversation.
The next day I received an email from the president of the company apologizing for the error and promising to look into the cause. The following day I received a very detailed letter shipped overnight via Fedex outlining the cause. I did not scan the letter due to all the personal information, but it was one of the most sincere letters I have ever read. It starts off with the following:
“I want to personally express my sincere apology to you and your entire family for the tremendously insensitive error that occurred on the Explanation of Benefitss (EOB) document that your wife, Carolyn, received. As a husband and a father myself, I cannot begin to comprehend the feelings evoked by our unacceptable mistake.”
The letter then goes into detail of the cause as well as the steps being taken to avoid this in the future. Steps included training for the staff as well as safeguards within their systems. There was also the attached personal note:
I am not writing this post to blast the company involved, in fact I would like to congratulate them. I think we would have all loved to see the mistake not happen in the first place, but it did. Mistakes do happen. The reason I want to congratulate them is too many people are afraid to simply apologize. I have spoken to service people who were either taught, or believed that any apology would open the door to legal liability. For some reason, and maybe it is due to the litigious society we are in, companies and people are afraid to apologize for a mistake. To me it means more than anything else that could be offered. The apology here was truly heartfelt and I am very appreciative of the handling by this company.
This is why it is so important to be genuine with a Customer.