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.]The insurance company did pay $towards the claim However that is nowhere near what should have been paid so farI have accumulated bills of over $8,with a deductible of only 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 Obviously, the HCC company didn't give any solutions or any apologiesThey said I submitted a blank document on Feb6, but the truth is I submitted the appeal on Febwhich is not blank because I submitted the same document again on March by email (That time they said it is successful)Even if that was indeed blank due to their website issues, I didn't receive any response or reply from them to notice me (they admitted they did receive some document).Actually my concern is why they denied my claimFrom the EOB letter they sent to me, it is very clear that the service provided by the doctor is related to my larynxIt's nothing related to the mental healthI went to see an ENT doctor (Dr [redacted] ***) who specializes in Otolaryngology,not mental healthHow could they connect a sore throat to mental disease? It's ridiculousAttached is the EOB letter which includes the service description (service code [redacted] and ***)None of these service are related to mental health.Thanks for your help, 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. Please understand that my Dad [redacted] did not have any preexisting condition.the symptoms were only noticed during his visit to US. Since he does not have any records of a preexisting medical condition in India. We request that this matter be resolved on an urgent basis. Please advice what we can provide to HCC Medical to open the file again. I have read information online that it is a common practice at this company to deny the claims made by the insured. Regards, [redacted] ***
This is in response to your recent inquiry on behalf of Ms [redacted] 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 itMs [redacted] purchased international travel coverage under our StudentSecure group travel insurance policy issued to the Atlas/International Citizens Group Insurance Trust, Hamilton BermudaMs [redacted] is a citizen and resident of ChinaThe insurance is underwritten by Lloyds Syndicate and HCC Medical Insurance Services (HCC MIS) is the Coverholder and AdministratorAfter review of the information on file, it has been determined that we have sufficient information form Ms [redacted] to complete processing the claims on fileThe claims have been approved and an updated explanation of benefits will be sent to Ms [redacted] directly within business days.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 knowSincerely, Lori L [redacted] Paralegal and Complaint Coordinator
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 Regards, [redacted] Dear [redacted] ***, (Revdex.com Agent), this is [redacted] Again, representing Mrs [redacted] , my mother in law, we are basically reopening complaint ID [redacted] , please open this complaint to see what we were promised by HCC Medical Insurance services, and they have not honoredOn the letter from HCC, dated 2-17-16, that we got thru you, the letter clearly states that the emergency visit Mrs [redacted] did on 12-6-was covered on the policy provisions, Mrs Lori L [redacted] from HCC even highlighted those provisionsNow a day later of the letter HCC sends me an explanation of benefits again denying coverage againWe believed in HCC promise to cover the emergency visit and we closed the complaint but now we want to reopen the complaintWe are attaching the following documents: -Letter from HCC dated 2-17-sent you (Revdex.com) saying that the emergency visit was covered -Explanation of benefits dated 2-18-sent after the letter saying they will not cover the emergency Dear [redacted] let me recall that FROM THE BEGINNING OUR INTENTION WAS TO GET INSURANCE MEDICAL COVERAGE FOR A VISITOR COMING INTO THE US TO USE IN CASE OF ILLNESS OR INJURYWE WERE OFFERED THAT COVERAGE AND WE PURCHASEDThey sold me a medical coverage for $50,maximum limit and $deductible per injury/illnessON PHONE CONVERSATIONS WITH HCC THEY AFFIRMED THAT IN CASE OF ILLNESS TO VISIT THE NEAREST HEALTH FACILITYTHEY HAVE TO COVER [redacted] BECAUSE THEY MADE US BELIEVE THEY WERE SELLING INSURANCE FOR THE PURPOSE OF ILLNESS OR INJURY [redacted] COVERAGE WEBSITE [redacted] SELLS [redacted] MEDICAL INSURANCE AND WE PAID THATPLEASE HELP US MAKE THINGS RIGHTAgain I will attach all supporting documentation I sent the first time, please contact HCC and ask why they do not want to honor their promised they did to you and usThanks you ***WE WANT HCC TO HONOR THEIR LETTER DATED 2-17-SENT TO YOU AND US, ON COMPLAINT ID [redacted] , SAYING THEY WILL COVER THE COMPLETE EXPENSE OF THE EMERGENCY VISIT ON 12-6-AS MRS LORI L [redacted] FROM HCC PROMISED ON THE LETTER
HCCMIS has re-evaluated the claims submissions for Mr [redacted] Upon review, we agree to reprocess claim number [redacted] as eligible (subject to deductible and coinsurance)We will reprocess this claim immediately and have it to repricingOnce the claim has returned from repricing, Mr [redacted] will receive new Explanation of BenefitsI 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.Sincerely, Jon P [redacted] HCC Medical Insurance Services
HCCMIS has reviewed the claims submissions for [redacted] and [redacted] *** Since we have received proof from the medical providers of timely filing of the insured claims, HCCMIS agrees to reprocess all claims as eligible (subject to copays, deductible and coinsurance) We will reprocess these claims immediately and have them sent to repricing Once the claims have returned from repricing, new Explanation of Benefits will be sent out 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
I have reviewed Mr***'s fileThe application required underwriting and was approved on January 11, A cancellation request was received on January 13, and processed the same dayAt that time, the premiums were refunded to Mr***.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company317/[email protected]
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] ***
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 partsI have attached below documents as a part of my reply.A)Pharmacy BillB)Policy Coverage DocumentsC) Doctor from PPO network.1) Mr [redacted] ( [redacted] )Below claim are currently in process statusHCC insurance deducted total 651.41USDBut as per plan, Coinsurance will be waived if providers are within the PPOI 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 - USDClaim # [redacted] Deductible - USDClaim # [redacted] Deductible - 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 (USD) to HCC Travel Insurance in connection with above claim but it is neither reflecting in the claim history nor processed by HCCI have filed pharmacy claim online through “zone.hccmis.com/clientzone” siteI’m attaching the copy of the claim taken from DocuSign site2) Mrs [redacted] ( [redacted] )As per earlier response from HCC, Claims # [redacted] , [redacted] , [redacted] , [redacted] , [redacted] and [redacted] are rejected due to pre-existing conditionBut as per policy document, Acute onset of pre-existing condition is covered up to overall maximum limit (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 careThe Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policyTreatment must be obtained within hours of the sudden and unexpected outbreak or recurrenceA Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute OnsetThis 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: 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]
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.]The insurance company did pay $towards the claim However that is nowhere near what should have been paid so farI have accumulated bills of over $8,with a deductible of only Regards, [redacted]
Please see the attached response for complaint # [redacted]
Please find attached HCC Life Insurance Company's response to your inquiry regarding Ms [redacted] Thank you
Please find attached 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 have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below Obviously, the HCC company didn't give any solutions or any apologiesThey said I submitted a blank document on Feb6, but the truth is I submitted the appeal on Febwhich is not blank because I submitted the same document again on March by email (That time they said it is successful)Even if that was indeed blank due to their website issues, I didn't receive any response or reply from them to notice me (they admitted they did receive some document).Actually my concern is why they denied my claimFrom the EOB letter they sent to me, it is very clear that the service provided by the doctor is related to my larynxIt's nothing related to the mental healthI went to see an ENT doctor (Dr [redacted] ***) who specializes in Otolaryngology,not mental healthHow could they connect a sore throat to mental disease? It's ridiculousAttached is the EOB letter which includes the service description (service code [redacted] and ***)None of these service are related to mental health.Thanks for your help, 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. Please understand that my Dad [redacted] did not have any preexisting condition.the symptoms were only noticed during his visit to US. Since he does not have any records of a preexisting medical condition in India. We request that this matter be resolved on an urgent basis. Please advice what we can provide to HCC Medical to open the file again. I have read information online that it is a common practice at this company to deny the claims made by the insured. Regards, [redacted] ***
Please find attached HCC Life Insurance Company's response to your inquiry regarding Mr [redacted] Thank you
This is in response to your recent inquiry on behalf of Ms [redacted] 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 itMs [redacted] purchased international travel coverage under our StudentSecure group travel insurance policy issued to the Atlas/International Citizens Group Insurance Trust, Hamilton BermudaMs [redacted] is a citizen and resident of ChinaThe insurance is underwritten by Lloyds Syndicate and HCC Medical Insurance Services (HCC MIS) is the Coverholder and AdministratorAfter review of the information on file, it has been determined that we have sufficient information form Ms [redacted] to complete processing the claims on fileThe claims have been approved and an updated explanation of benefits will be sent to Ms [redacted] directly within business days.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 knowSincerely, Lori L [redacted] Paralegal and Complaint Coordinator
Please see the attached response to Revdex.com Id number [redacted] Thank you, Lori L***
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 Regards, [redacted] Dear [redacted] ***, (Revdex.com Agent), this is [redacted] Again, representing Mrs [redacted] , my mother in law, we are basically reopening complaint ID [redacted] , please open this complaint to see what we were promised by HCC Medical Insurance services, and they have not honoredOn the letter from HCC, dated 2-17-16, that we got thru you, the letter clearly states that the emergency visit Mrs [redacted] did on 12-6-was covered on the policy provisions, Mrs Lori L [redacted] from HCC even highlighted those provisionsNow a day later of the letter HCC sends me an explanation of benefits again denying coverage againWe believed in HCC promise to cover the emergency visit and we closed the complaint but now we want to reopen the complaintWe are attaching the following documents: -Letter from HCC dated 2-17-sent you (Revdex.com) saying that the emergency visit was covered -Explanation of benefits dated 2-18-sent after the letter saying they will not cover the emergency Dear [redacted] let me recall that FROM THE BEGINNING OUR INTENTION WAS TO GET INSURANCE MEDICAL COVERAGE FOR A VISITOR COMING INTO THE US TO USE IN CASE OF ILLNESS OR INJURYWE WERE OFFERED THAT COVERAGE AND WE PURCHASEDThey sold me a medical coverage for $50,maximum limit and $deductible per injury/illnessON PHONE CONVERSATIONS WITH HCC THEY AFFIRMED THAT IN CASE OF ILLNESS TO VISIT THE NEAREST HEALTH FACILITYTHEY HAVE TO COVER [redacted] BECAUSE THEY MADE US BELIEVE THEY WERE SELLING INSURANCE FOR THE PURPOSE OF ILLNESS OR INJURY [redacted] COVERAGE WEBSITE [redacted] SELLS [redacted] MEDICAL INSURANCE AND WE PAID THATPLEASE HELP US MAKE THINGS RIGHTAgain I will attach all supporting documentation I sent the first time, please contact HCC and ask why they do not want to honor their promised they did to you and usThanks you ***WE WANT HCC TO HONOR THEIR LETTER DATED 2-17-SENT TO YOU AND US, ON COMPLAINT ID [redacted] , SAYING THEY WILL COVER THE COMPLETE EXPENSE OF THE EMERGENCY VISIT ON 12-6-AS MRS LORI L [redacted] FROM HCC PROMISED ON THE LETTER
HCCMIS has re-evaluated the claims submissions for Mr [redacted] Upon review, we agree to reprocess claim number [redacted] as eligible (subject to deductible and coinsurance)We will reprocess this claim immediately and have it to repricingOnce the claim has returned from repricing, Mr [redacted] will receive new Explanation of BenefitsI 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.Sincerely, Jon P [redacted] HCC Medical Insurance Services
please see the attached response to the following complaint: RE: Complainant: [redacted] IN Revdex.com File #: [redacted] Thank you, Lori
HCCMIS has reviewed the claims submissions for [redacted] and [redacted] *** Since we have received proof from the medical providers of timely filing of the insured claims, HCCMIS agrees to reprocess all claims as eligible (subject to copays, deductible and coinsurance) We will reprocess these claims immediately and have them sent to repricing Once the claims have returned from repricing, new Explanation of Benefits will be sent out 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
I have reviewed Mr***'s fileThe application required underwriting and was approved on January 11, A cancellation request was received on January 13, and processed the same dayAt that time, the premiums were refunded to Mr***.If I can be of further assistance, please let me know.Respectfully, Lori L***ParalegalHCC Life Insurance Company317/[email protected]
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] ***
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 partsI have attached below documents as a part of my reply.A)Pharmacy BillB)Policy Coverage DocumentsC) Doctor from PPO network.1) Mr [redacted] ( [redacted] )Below claim are currently in process statusHCC insurance deducted total 651.41USDBut as per plan, Coinsurance will be waived if providers are within the PPOI 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 - USDClaim # [redacted] Deductible - USDClaim # [redacted] Deductible - 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 (USD) to HCC Travel Insurance in connection with above claim but it is neither reflecting in the claim history nor processed by HCCI have filed pharmacy claim online through “zone.hccmis.com/clientzone” siteI’m attaching the copy of the claim taken from DocuSign site2) Mrs [redacted] ( [redacted] )As per earlier response from HCC, Claims # [redacted] , [redacted] , [redacted] , [redacted] , [redacted] and [redacted] are rejected due to pre-existing conditionBut as per policy document, Acute onset of pre-existing condition is covered up to overall maximum limit (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 careThe Acute Onset of a Pre-existing Condition(s) must occur after the effective date of the policyTreatment must be obtained within hours of the sudden and unexpected outbreak or recurrenceA Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute OnsetThis 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: 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]