Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.
Regards,
[redacted]
Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]Regards,[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.It is not possible for anyone to assume that the symptoms existed during application and fever can begin at any moment. In addition; when someone gets sick they don't run to the doctor right away. Mr. [redacted] was not aware that he was suffering the symptoms of Malaria hence he did not run to the ER right away. Its with reasonable certainty that I can say that not everyone runs to the ER when they get a fever or feel ill. Usually people take OTC medication to relieve the symptoms.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[Provide details of why you are not satisfied with this resolution.] Hi,I’m dividing my response in two parts. I have attached below documents as a part of my reply.A)Pharmacy BillB)Policy Coverage DocumentsC) Doctor from PPO network.1) Mr [redacted])Below claim are currently in process status. HCC insurance deducted total 651.41USD. But as per plan, Coinsurance will be waived if providers are within the PPO. I have attached screenshot taken from HCCMIS site, showing Dr. [redacted] and Dr. [redacted] are belong to HCCMIS PPO.Here is snippet from the plan document.“ Coinsurance will be waived if expenses are incurred within the PPO and expensesare submitted to Underwriters for review and payment directly to the provider”Claim # [redacted] Deductible - 59.40 USDClaim # [redacted] Deductible - 500 USDClaim # [redacted] Deductible - 92.01 USDI request you to pls re-process above claims so that deductibles can be taken care of by HCC Travel Insurance.Also, I have sent pharmacy claim (198.99 USD) to HCC Travel Insurance in connection with above claim but it is neither reflecting in the claim history nor processed by HCC. I have filed pharmacy claim online through “zone.hccmis.com/clientzone” site. I’m attaching the copy of the claim taken from DocuSign site. 2) Mrs. [redacted])As per earlier response from HCC, Claims # [redacted] and [redacted] are rejected due to pre-existing condition. But as per policy document, Acute onset of pre-existing condition is covered up to overall maximum limit (100000 USD for Mrs. [redacted])“Acute Onset of Pre-existing Condition: The term “Acute Onset of a Pre-Existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.”I humbly request you to please re-consider above claims for Mrs. [redacted].
Regards,
[redacted]
Revdex.com:Thank you for your help.
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.
Regards,
[redacted]
Ms. [redacted]'s claims have now completed processing and an updated explanation of benefits was sent to both the policy holder and provider for each claim.If I can be of further assistance, please let me know.Respectfully, Lori L[redacted]ParalegalHCC Life Insurance Companyl[redacted]@hccmis.com317/221-8013
Please see the attached response in regards to the below complaint: RE: Complainant: [redacted] Policy Holder: [redacted] ID# [redacted] IN Revdex.com File...
After again reviewing Mr. [redacted]' file, the claims he has referenced have been processed according to the terms and conditions of the plan. Today I am mailing the explanation of benefits for each claim to Mr. [redacted] directly.If I can be of further assistance, please let me know.Respectfully, Lori L[redacted]ParalegalHCC Life Insurance Company317/221-8013ll[redacted]@hccmis.com
Ms. [redacted] was covered under our Atlas policy which is issued on a non-admitted basis to The Atlas/International Citizen Group Insurance Trust out of Hamilton, Bermuda. The insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administrator. ...
HCCMIS has re-evaluated the claims submissions for Ms. [redacted]. Upon review, we agree with Ms. [redacted] that claims for eye/allergy were incorrectly denied and should be considered eligible for payment (subject to deductible and coinsurance). We will reprocess these claims immediately. We apologize for the delay and inconvenience encountered by Ms. [redacted] regarding the denial of these claims. Ms. [redacted] will receive new Explanation of Benefits for these reprocessed shortly. For claims submitted for ulcerative colitis and anemia, these conditions were found to be pre-existing conditions based on the Claimant’s Statement and Authorization Form and the medical records received by HCCMIS. Since pre-existing conditions are excluded under the policy, these claims were properly denied. I hope this information will allow the Bureau to conclude the handling of this file. If I can be of any further assistance, please let me know. Sincerely, Jon P[redacted] HCC Medical Insurance Services
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below:I will happily accept the offer made by HCCMIS, as long as all my medical bills pertaining to Eye Consultants, Allergy Consultant, Hemotology Consultant, Iron IV Transfusions, MRI, Blood Tests (as all were investigative) ordered by different consultants are paid in full. Not forgetting that I had a policy which had $0.00 deductible. I am studying full time, however, I will try my best to chase every doctor for my medical records to be provided to HCCMIS, this however is undue and uncalled for stress.Also, I want it to be noted by Revdex.com that this insurance was misold by way of misrepresentation by HCCMIS Agent who advised my mother that I will be FULLY COVERED even for UC. This is the reason my mother purchased the insurance from HCCMIS as other Insurance providers were offering a 6 month waiting period for pre-existing conditions. This in my view is illegal. Surprisingly I haven't received an apology or any form of compensation from HCCMIS, considering the harassment and immense stress they have caused by wrongfully denying my claims.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
This is their modus operandi. Not only with me but at least 47 others that I have been in contact with. They have ALL I strongly repeat ALL of the paperwork from the doctors here in Spain. The claim for the hospital indemnity was issued in January wich if my calander is the same as theirs 4 months BEFORE the end of my contract. They also repeatedly delay giving any form of answer. It was not a Tumor nor a mass. as their so called ¨doctors ¨claim. They have been given any and all paperwork required. They continue to twist everything that they say. In January I sent all forms to them for the hospital indemnity. They also sent me docusign forms. On them there are NO ADITTIONAL forms to be required. Now I see they are headquarterd in Bermuda, a safe haven for thieves. They continue to delay and delay to the point I was rudely told 90 Business days for an answer in March. Obviously they do not have a patient in mind when they take the money. When I called not once was other paperwork asked for, not once. I have also explained the situation to the Spanish Consulate as I have now a much superior insurance plan at a fraction of what they charge. They try to delay and manipulate everything to avoid any and all payments.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.It seems as if this will not be resolved as both of us do not agree.
Regards,
[redacted]
Please find HCC Life Insurance Company's response to your inquiry regarding Mr. [redacted]. Thank you
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.
Regards,
[redacted]
Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.[Provide details of why you are not satisfied with this resolution.]Regards,[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.It is not possible for anyone to assume that the symptoms existed during application and fever can begin at any moment. In addition; when someone gets sick they don't run to the doctor right away. Mr. [redacted] was not aware that he was suffering the symptoms of Malaria hence he did not run to the ER right away. Its with reasonable certainty that I can say that not everyone runs to the ER when they get a fever or feel ill. Usually people take OTC medication to relieve the symptoms.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
[Provide details of why you are not satisfied with this resolution.] Hi,I’m dividing my response in two parts. I have attached below documents as a part of my reply.A)Pharmacy BillB)Policy Coverage DocumentsC) Doctor from PPO network.1) Mr [redacted])Below claim are currently in process status. HCC insurance deducted total 651.41USD. But as per plan, Coinsurance will be waived if providers are within the PPO. I have attached screenshot taken from HCCMIS site, showing Dr. [redacted] and Dr. [redacted] are belong to HCCMIS PPO.Here is snippet from the plan document.“ Coinsurance will be waived if expenses are incurred within the PPO and expensesare submitted to Underwriters for review and payment directly to the provider”Claim # [redacted] Deductible - 59.40 USDClaim # [redacted] Deductible - 500 USDClaim # [redacted] Deductible - 92.01 USDI request you to pls re-process above claims so that deductibles can be taken care of by HCC Travel Insurance.Also, I have sent pharmacy claim (198.99 USD) to HCC Travel Insurance in connection with above claim but it is neither reflecting in the claim history nor processed by HCC. I have filed pharmacy claim online through “zone.hccmis.com/clientzone” site. I’m attaching the copy of the claim taken from DocuSign site. 2) Mrs. [redacted])As per earlier response from HCC, Claims # [redacted] and [redacted] are rejected due to pre-existing condition. But as per policy document, Acute onset of pre-existing condition is covered up to overall maximum limit (100000 USD for Mrs. [redacted])“Acute Onset of Pre-existing Condition: The term “Acute Onset of a Pre-Existing Condition(s)” shall mean a sudden and unexpected outbreak or recurrence of a Pre-existing Condition(s) which occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or Treatments existent or necessary prior to the Effective Date of coverage.”I humbly request you to please re-consider above claims for Mrs. [redacted].
Regards,
[redacted]
Revdex.com:Thank you for your help.
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution would be satisfactory to me.
Regards,
[redacted]
Ms. [redacted]'s claims have now completed processing and an updated explanation of benefits was sent to both the policy holder and provider for each claim.If I can be of further assistance, please let me know.Respectfully, Lori L[redacted]ParalegalHCC Life Insurance Companyl[redacted]@hccmis.com317/221-8013
Please see the attached response in regards to the below complaint: RE: Complainant: [redacted] Policy Holder: [redacted] ID# [redacted] IN Revdex.com File...
#: [redacted] Thank you, Lori
Please see the attached response to Revdex.com Id number [redacted]. Thank you, Lori L[redacted]
After again reviewing Mr. [redacted]' file, the claims he has referenced have been processed according to the terms and conditions of the plan. Today I am mailing the explanation of benefits for each claim to Mr. [redacted] directly.If I can be of further assistance, please let me know.Respectfully, Lori L[redacted]ParalegalHCC Life Insurance Company317/221-8013ll[redacted]@hccmis.com
Ms. [redacted] was covered under our Atlas policy which is issued on a non-admitted basis to The Atlas/International Citizen Group Insurance Trust out of Hamilton, Bermuda. The insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administrator. ...
HCCMIS has re-evaluated the claims submissions for Ms. [redacted]. Upon review, we agree with Ms. [redacted] that claims for eye/allergy were incorrectly denied and should be considered eligible for payment (subject to deductible and coinsurance). We will reprocess these claims immediately. We apologize for the delay and inconvenience encountered by Ms. [redacted] regarding the denial of these claims. Ms. [redacted] will receive new Explanation of Benefits for these reprocessed shortly. For claims submitted for ulcerative colitis and anemia, these conditions were found to be pre-existing conditions based on the Claimant’s Statement and Authorization Form and the medical records received by HCCMIS. Since pre-existing conditions are excluded under the policy, these claims were properly denied. I hope this information will allow the Bureau to conclude the handling of this file. If I can be of any further assistance, please let me know. Sincerely, Jon P[redacted] HCC Medical Insurance Services
Please see the attached response to this complaint.
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below:I will happily accept the offer made by HCCMIS, as long as all my medical bills pertaining to Eye Consultants, Allergy Consultant, Hemotology Consultant, Iron IV Transfusions, MRI, Blood Tests (as all were investigative) ordered by different consultants are paid in full. Not forgetting that I had a policy which had $0.00 deductible. I am studying full time, however, I will try my best to chase every doctor for my medical records to be provided to HCCMIS, this however is undue and uncalled for stress.Also, I want it to be noted by Revdex.com that this insurance was misold by way of misrepresentation by HCCMIS Agent who advised my mother that I will be FULLY COVERED even for UC. This is the reason my mother purchased the insurance from HCCMIS as other Insurance providers were offering a 6 month waiting period for pre-existing conditions. This in my view is illegal. Surprisingly I haven't received an apology or any form of compensation from HCCMIS, considering the harassment and immense stress they have caused by wrongfully denying my claims.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.
This is their modus operandi. Not only with me but at least 47 others that I have been in contact with. They have ALL I strongly repeat ALL of the paperwork from the doctors here in Spain. The claim for the hospital indemnity was issued in January wich if my calander is the same as theirs 4 months BEFORE the end of my contract. They also repeatedly delay giving any form of answer. It was not a Tumor nor a mass. as their so called ¨doctors ¨claim. They have been given any and all paperwork required. They continue to twist everything that they say. In January I sent all forms to them for the hospital indemnity. They also sent me docusign forms. On them there are NO ADITTIONAL forms to be required. Now I see they are headquarterd in Bermuda, a safe haven for thieves. They continue to delay and delay to the point I was rudely told 90 Business days for an answer in March. Obviously they do not have a patient in mind when they take the money. When I called not once was other paperwork asked for, not once. I have also explained the situation to the Spanish Consulate as I have now a much superior insurance plan at a fraction of what they charge. They try to delay and manipulate everything to avoid any and all payments.
Regards,
[redacted]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below.It seems as if this will not be resolved as both of us do not agree.
Regards,
[redacted]