We have again reviewed the claims on file for Ms***'s childMs*** states that the routine claims must be paid in full however, that is not correctThe benefits are subject to the policy holder's deductible and coinsunanceThe claims have appropriately processed per the policy guidelines and applied to her deductible.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company*** - directll***@hccmis.com
Revdex.com:
I have reviewed the response made by the business in reference to
complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below
please explain why we are looking at TWO "Not Covered" in this.
Regards,
*** ***
RE: Complainant: *** *** ID number:*** IN Revdex.com File#: *** Dear Ms*** This is in response to your recent follow up inquiry on behalf of Ms***. Please be aware that this response may contain personal health information on the claimantWe trust the Department will only make this information available to those persons authorized to receive it Ms.*** purchased international travel coverage under our StudentSecure group travel insurance policy issued to the *** *** Group Insurance Trust, *** ***Ms*** is a citizen and resident of ChinaThe insurance is underwritten by *** *** *** and HCC Medical Insurance Services (HCC MIS) is the Coverholder and Administrator The Explanation of Benefits Ms*** is referring to was sent prior to our April 7,responseThere have been no additional requesets madeThe claims pending student information have now been approvedIf Ms*** has not yet received the explanation of benefits via regular mail, those will arrive shortly I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me know Lori L*** Paralegal and Complaint Coordinator HCC Medical Insurance Services 317/221-l***@hccmis.com
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to meI have attached my detailed response to HCCMIS with this message.Thank you Revdex.com for helping us reach an appropriate resolution, and will keep you informed on the resolution's execution status
Regards,
*** ***
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear belowThe reason as to why I am not satisfied is because today I called the number provided in the response email to talk to an individual to check on the reason as to why the medical records are not being processed by the insurance companyWhen I got connected to an attorney there he was very rude, didn't let me speak when I was talking and pretty much summed it up as, it's not their fault that they are not receiving the records being requested by themHe was even mocking me at one point when I said this situation is causing me extra unneeded stress by saying aww and having an attitude with meHe even threatened me and said that if he does not receive any medical records he will close my file and I will have to pay all of my hospital bills which exceed over 50,dollarsWhen I asked about the current situation of my request he said he did not check anything for the past days and when I said the reason I feel stressed is because the bills are writing in red bold letters "final notice before being reported to collections" he told me I shouldn't worry about that and that waiting two months to get this resolved is a small time span! It is all getting out of control! Never have I felt so defeated and disrespected after a phone call and now just to appease him I am going to take more time out of my day to call all of the bills and tell them to wait and pay to get my medical records from the hospital just to fax it to him so that in his words I'm not committing fraud! Honestly it was the worst phone call I ever been in with the constant talking in circles about how they are not at fault for anything when at the same time they aren't making the calls or taking the effort to come to a solution at accessing the records! He said that he called the hospital and now he has to wait! He doesn't have to wait! When I called the hospital they told me in order to get the records soon I just have to have to write expedite on the bottom of the request form! They are just lying and wasting time in order to not take responsibility in paying any of the hospital bills.Regards,*** ***
Dear Ms***: Ms*** ***, a citizen of China, was covered under our Atlas Travel policy which is issued on a non-admitted basis to The Atlas/International Citizen Group Insurance Trust out of Hamilton, Bermuda during his trip to the United StatesThe insurance is underwritten by Lloyds,
London and Tokio Marine HCC Medical Insurance Services Group (TMHCCMIS) is the administratorThe policy was effective from September 29, to March 16,Ms*** was treated on January 12, The primary diagnosis billed by the provider is for a mental health c.ondition, which is a direct exclusion from the plan Ms*** alleges that she submitted an appeal multiple times; however, on January 6, a blank document was received from Ms***On March 7, Ms***'s appeal was submittedThat appeal is currently under reviewA response is due to Ms*** within 7-business days Ms*** also alleges that a one sentence response was provided when she inquired on her appealThat is incorrectA transcript of the inquiry has been reviewed and a conversation was held with Ms*** on March 20, explaining the receipt of the blank documents and the processing time for the appealMs*** was asked if she had any additional questions and she replied that she did notAt that time she was advised to contact us with any additional questions I hope this information will allow the Department to conclude the handling of this fileIf I can be of any further assistance, please let me know Sincerely, Lori L*** Paralegal and Complaints Coordinator
Ms*** purchased international travel coverage under our VacationUSA programMs*** applied for coverage under our Group Master Policy issued to the Atlas/International Citizens Group Insurance Trust, Hamilton BermudaThis insurance is underwritten by Lloyds, London and HCC Medical Insurance
Services (HCCMIS) is the Coverholder and Administrator
Ms***, a citizen of Taiwan, purchased coverage with an effective date of May 16, and termination date of August 15,
Ms***'s address has been updated in our system as of February 12, We have waived the timely filing provision of the policy and approved Ms***'s claimsA new explanation of benefits for each claim will be sent to Ms*** within 10-business days
I hope this information will allow the Department to conclude the handling of this fileIf I can be of any further assistance, please let me know.Sincerely
Lori ***Paralegal and Complaint Coordinator HCC Medical Insurance Services 317/221-8013l***@hccmis.com
After review of Ms***'s file we agree with Ms***Consequently, we have corrected our error and apologized for her inconvenience.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company317/221-8013***@hccmis.com
I apologize if Mr*** felt I was rude or offended him in any mannerI tried to explain the information we needed to process his claimWhile we have requested these records from his providers, I suggested that he also call his providers to indicate we were waiting for these records to process his claimsWe are continuing our efforts to obtain his records, but until these records are received, we are unable to move forward
I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of further assistance, please let me know
Respectfully,
Charles ** ***, Esq
Ms*** 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. This policy is not an Affordable Care Act (ACA) policy and does not meet the minimum standards required by the health care reform law. Therefore, the Atlas policy may legally contain a pre-exisiting exclusion HCCMIS is willing to reconsider the anemia claims denials; however, Ms*** must provide all medical records from Dr*** *** and *** *** Med. HCCMIS will request these records from the provider; however, Ms*** may be able to expidiate the medical records request In regards to all ulcerative coliatis claims, these claims were correctly denied pre-existing and will remain denied as such 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*** HCC Medical Insurance Services
Please find HCC Life Insurance Company's response to the inquiry concerning Mr*** ***. Thank you
We have again reviewed the claims on file for Ms***'s childMs*** states that the routine claims must be paid in full however, that is not correctThe benefits are subject to the policy holder's deductible and coinsunanceThe claims have appropriately processed per the policy guidelines and applied to her deductible.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company*** - directll***@hccmis.com
Revdex.com:
I have reviewed the response made by the business in reference to
complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below
please explain why we are looking at TWO "Not Covered" in this.
Regards,
*** ***
See Attached Response
Please find attached HCC Life Insurance Company's response to the most recent inquiry received regarding Mr*** ***. Thank you
RE: Complainant: *** *** ID number:*** IN Revdex.com File#: *** Dear Ms*** This is in response to your recent follow up inquiry on behalf of Ms***. Please be aware that this response may contain personal health information on the claimantWe trust the Department will only make this information available to those persons authorized to receive it Ms.*** purchased international travel coverage under our StudentSecure group travel insurance policy issued to the *** *** Group Insurance Trust, *** ***Ms*** is a citizen and resident of ChinaThe insurance is underwritten by *** *** *** and HCC Medical Insurance Services (HCC MIS) is the Coverholder and Administrator The Explanation of Benefits Ms*** is referring to was sent prior to our April 7,responseThere have been no additional requesets madeThe claims pending student information have now been approvedIf Ms*** has not yet received the explanation of benefits via regular mail, those will arrive shortly I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me know Lori L*** Paralegal and Complaint Coordinator HCC Medical Insurance Services 317/221-l***@hccmis.com
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, 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,
*** ***
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and find that this resolution would be satisfactory to meI have attached my detailed response to HCCMIS with this message.Thank you Revdex.com for helping us reach an appropriate resolution, and will keep you informed on the resolution's execution status
Regards,
*** ***
Revdex.com:I have reviewed the response made by the business in reference to complaint ID ***, and have determined that the response would not resolve my complaint. For your reference, details of the offer I reviewed appear belowThe reason as to why I am not satisfied is because today I called the number provided in the response email to talk to an individual to check on the reason as to why the medical records are not being processed by the insurance companyWhen I got connected to an attorney there he was very rude, didn't let me speak when I was talking and pretty much summed it up as, it's not their fault that they are not receiving the records being requested by themHe was even mocking me at one point when I said this situation is causing me extra unneeded stress by saying aww and having an attitude with meHe even threatened me and said that if he does not receive any medical records he will close my file and I will have to pay all of my hospital bills which exceed over 50,dollarsWhen I asked about the current situation of my request he said he did not check anything for the past days and when I said the reason I feel stressed is because the bills are writing in red bold letters "final notice before being reported to collections" he told me I shouldn't worry about that and that waiting two months to get this resolved is a small time span! It is all getting out of control! Never have I felt so defeated and disrespected after a phone call and now just to appease him I am going to take more time out of my day to call all of the bills and tell them to wait and pay to get my medical records from the hospital just to fax it to him so that in his words I'm not committing fraud! Honestly it was the worst phone call I ever been in with the constant talking in circles about how they are not at fault for anything when at the same time they aren't making the calls or taking the effort to come to a solution at accessing the records! He said that he called the hospital and now he has to wait! He doesn't have to wait! When I called the hospital they told me in order to get the records soon I just have to have to write expedite on the bottom of the request form! They are just lying and wasting time in order to not take responsibility in paying any of the hospital bills.Regards,*** ***
Please see the attached response to the following complaint: RE: Complainant: *** *** IN Revdex.com File #: *** Thank you, Lori L***
Dear Ms***: Ms*** ***, a citizen of China, was covered under our Atlas Travel policy which is issued on a non-admitted basis to The Atlas/International Citizen Group Insurance Trust out of Hamilton, Bermuda during his trip to the United StatesThe insurance is underwritten by Lloyds,
London and Tokio Marine HCC Medical Insurance Services Group (TMHCCMIS) is the administratorThe policy was effective from September 29, to March 16,Ms*** was treated on January 12, The primary diagnosis billed by the provider is for a mental health c.ondition, which is a direct exclusion from the plan Ms*** alleges that she submitted an appeal multiple times; however, on January 6, a blank document was received from Ms***On March 7, Ms***'s appeal was submittedThat appeal is currently under reviewA response is due to Ms*** within 7-business days Ms*** also alleges that a one sentence response was provided when she inquired on her appealThat is incorrectA transcript of the inquiry has been reviewed and a conversation was held with Ms*** on March 20, explaining the receipt of the blank documents and the processing time for the appealMs*** was asked if she had any additional questions and she replied that she did notAt that time she was advised to contact us with any additional questions I hope this information will allow the Department to conclude the handling of this fileIf I can be of any further assistance, please let me know Sincerely, Lori L*** Paralegal and Complaints Coordinator
Please provide the insured name and policy/certificate number
Ms*** purchased international travel coverage under our VacationUSA programMs*** applied for coverage under our Group Master Policy issued to the Atlas/International Citizens Group Insurance Trust, Hamilton BermudaThis insurance is underwritten by Lloyds, London and HCC Medical Insurance
Services (HCCMIS) is the Coverholder and Administrator
Ms***, a citizen of Taiwan, purchased coverage with an effective date of May 16, and termination date of August 15,
Ms***'s address has been updated in our system as of February 12, We have waived the timely filing provision of the policy and approved Ms***'s claimsA new explanation of benefits for each claim will be sent to Ms*** within 10-business days
I hope this information will allow the Department to conclude the handling of this fileIf I can be of any further assistance, please let me know.Sincerely
Lori ***Paralegal and Complaint Coordinator HCC Medical Insurance Services 317/221-8013l***@hccmis.com
Please see the attached response to the below complaint: RE: Complainant: *** *** and *** *** ID# *** IN Revdex.com File #: *** Thank you, Lori
Please find attached HCC Life Insurance Company's response to your inquiry regarding Mr*** *** Thank you
Please find attached HCC Life Insurance Company's response to your inquiry regarding Ms*** ***. Thank you
After review of Ms***'s file we agree with Ms***Consequently, we have corrected our error and apologized for her inconvenience.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company317/221-8013***@hccmis.com
I apologize if Mr*** felt I was rude or offended him in any mannerI tried to explain the information we needed to process his claimWhile we have requested these records from his providers, I suggested that he also call his providers to indicate we were waiting for these records to process his claimsWe are continuing our efforts to obtain his records, but until these records are received, we are unable to move forward
I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of further assistance, please let me know
Respectfully,
Charles ** ***, Esq
Ms*** 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. This policy is not an Affordable Care Act (ACA) policy and does not meet the minimum standards required by the health care reform law. Therefore, the Atlas policy may legally contain a pre-exisiting exclusion HCCMIS is willing to reconsider the anemia claims denials; however, Ms*** must provide all medical records from Dr*** *** and *** *** Med. HCCMIS will request these records from the provider; however, Ms*** may be able to expidiate the medical records request In regards to all ulcerative coliatis claims, these claims were correctly denied pre-existing and will remain denied as such 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*** HCC Medical Insurance Services
Please find HCC Life Insurance Company's response to the most recent inquiry attached. Thank you