Combined Insurance Company

I have had Combined Insurance for over 5 years. Last year I had surgery and a stroke. Combined's claim service was excellent! They paid me for coverages I wasn't even aware of. I am in the property & casualty insurance business and never miss an opportunity to share my experience. I recommend Combined to everyone that the subject arises with.

Initial Business Response /* (1000, 5, 2014/06/11) */
See attached response.

As stated in our June 3, 2016 response to you, since the disclosure of Mr. [redacted]’s claim information is strictly prohibited, in accordance with our Privacy Pledge as well as HIPAA (Health Insurance Portability and Accountability Act) regulations, we are unable to provide any further information to you at this time.
 
Be assured that after speaking with Mrs. [redacted] by phone on June 1, 2016 our June 3, 2016 correspondence was mailed directly to her addressing the concerns expressed in her call to us as well as her inquiry to you.  Furthermore, we have now received correspondence from the [redacted] on behalf of Mrs. [redacted] and we will be responding to them directly.
 
If you have any questions, please let us know.
 
Sincerely,
Tamara [redacted], Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
(toll free) ###-###-####

I have submitted a SICKPAY Plus claim and the claims dept. has done nothing but the run around to pay me on my claim. I submitted my Dr. note, physician statement, the company from state short term disability proof, employer proof that I am off from work for the next 3 months, a copy of my HIPAA form from my initial application. And they still have not approved my claim. I am a current policy holder and military veteran spouse and I am completely disguised with how my claim has been handled. I am recommending EVERYONE to STAY AWAY FROM THIS COMPANY. My claim number 28215308 to prove to combined insurance this is a LEGIT COMPLAINT , that I will be escalating this to the commissioner and seeking legal counsel now. Consumer BEWARE- They will NOT want to pay you on your claims and give you every ** to not pay you.

Dear Customer:
Thank you for your recent inquiry.  You should be hearing from our Claims department shortly regarding your concern.
If you should have any questions in the meantime, please contact us at 1-800-[redacted] for further...

assistance. 
Combined Insurance

I recently moved out of the Grand Traverse area. I called the insurance agent Jackie [redacted] many times to cancel my services!! I finally spoke with a lady through your 1800 numer to cancel and the said it would be taken care of.. My account was charged again. My understanding From Jackie [redacted] this was a cancel at anytime policy.. I feel as though im being taken advantage of!! I cant afford this insurance and they have been taking the payment out for the last 4 months after I canceled. Jackie [redacted] hasnt tried to contact me until I thought I had it all taken care of with the lady on the phone. Now he tries to contact me?? Then I get a message on my phone at 6:00 a.m. that my account is overdrawn again from combined Insurance go figure!!!!

In accordance with our Privacy Pledge as well as HIPAA (Health Insurance Portability and Accountability...

Act) regulations, it is our goal to protect all confidential policyholder information, specifically regarding claims, while continuing to provide high quality service to our customers.
 
As the disclosure of Mr. [redacted]’s policy benefits and claim information is strictly prohibited, we
are unable to provide any further information to you at this time. However, be assured that we
have mailed correspondence directly to Mr. [redacted], addressing the concerns expressed in his inquiry to you.  He should receive our letter within the next 10-15 business days.
 
If you have any questions, please do not hesitate to contact us.
 
Sincerely,
Tamara *. [redacted], Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
(toll free) 1-800-225-4500
(fax) 1-312-351-6910

Initial Business Response /* (1000, 5, 2015/08/28) */
August 28, 2015
Revdex.com
330 N. Wabash Avenue, Suite 3120
Chicago, IL XXXXX-XXXX
Re: Complaint ID #: XXXXXXXX
Consumer: [redacted]

Dear Revdex.com Customer Relations Advocate:
This letter is being provided...

in response to Ms. [redacted]'s August 19, 2015 inquiry to your office.
Prompted by your inquiry to us, we reviewed our records and learned the following.
Ms. [redacted] applied for a policy through an agent of our company on August 13, 2015. On August 19, 2015, she faxed a signed policy cancellation/refund request letter to our company. On August 25, 2015, we mailed her a full premium refund check. On that same day, we also mailed a letter to her in a separate envelope in order to acknowledge that her policy was cancelled and that a full premium refund had been processed.
Her policy is now being considered null and void from the beginning.
While we trust that this letter satisfactorily responds to your inquiry, if you have any questions, or if I can be of further assistance, please let me know.
Sincerely,
[redacted], Senior Coordinator
[redacted] Insurance Company of America
Consumer Service Investigations
Direct: (XXX) XXX-XXXX
Toll Free: (XXX) XXX-XXXX / Ext XXXXX
FAX: (XXX) XXX-XXXX
Case #XXXXXXX

I needed to change the account that Combined Insurance Company takes money from each month for my premium. I called the customer service phone number give them all of the new banking information along with correct account numbers and routing numbers for this different bank that I wanted the premium to be taken from. This bank account that I wanted to change to has plenty of money in it and always has. T his premium is only $33 per month ,so combined sent me a letter saying they cannot withdraw the money- there is a problem & they did not identify what the problem was ,they just said it was a problem.. I go to our bank and question the manager and explain the situation I am told by the bank manager this Bank has nothing to do with the problemit. I have done everything correctly as a customer & the bank claims they allow combined to take the premium money out each month.. I am told by the bank manager that there is a problem with the combined system that is preventing the money to be withdrawn. That is what I was told. I am now armed with the information from my bank concerning this problem and I contact Combined Insurance once again and tell them what I found out . as you can imagine combined says nearly the same thing, the problem is with your bank and not Combined Insurance Company they say . Meanwhile I get five notices in the mail from Combined Insurance telling me that the premium is late . I called combined a third time and they are speaking like robots just droning on about the same thing and repeating themself about everything that has already transpired and things that are already known .. They're not offering any solution .. They sound like a broken record. I get absolutely Nowhere .. finally asked to speak to my agent and they tell me I cannot have his phone number, but he will call me within 7 days & he is not allowed to speak to me about payments or things like that ; but only new Services if I wish to purchase.. However when I originally signed on with Combined Insurance nearly 10 years ago the agent was very forthcoming about telling me theyre open to phone calls anytime for any reason regarding my policy.. This has put me in a position and I don't know how to fix. Ive done everything in my power to pay combined & as I indicated before this is not a matter of me not having the funds this is a matter of getting payment from point A to point B... Two large companies can't seem to work it out, meaning my bank and Combined Insurance. Nowl this policy has absolutely lapsed and combined refuses to take a over the phone payment from me not even with a credit card . I asked them if they would take a credit card number and just take it from that every single month because I felt that would be the easiest thing to do and they refused to do that. They seem to be extremely picky about how they want to be paid it's sad to say that I'm trying to pay the company and they just don't want to take my money or even try to help themselves take the money by looking into the problem .they're driving me crazy. Iit's a fairly simple concept that happens millions of times per day between companies and banking institutions millions of times per day ... why am I having a problem and why can't two big companies work it out amongst themselves?

Initial Business Response /* (1000, 5, 2014/09/12) */
September 12, 2014
Revdex.com
330 Lower Wabash
Chicago, IL 60611
Re: Your Case Number: XXXXXXXX
Insured/Complainant: [redacted]
Dear Ms. [redacted]
This letter is being provided in response to Ms. [redacted]'s...

inquiry to your office.
Ms. [redacted] owns two policies through Combined Life Insurance Company of New York. One policy is an Accident and Sickness Protector Policy. The other is an Income Protector Policy. Both policies were issued October 5, 2013.
On August 4, 2014, our company received Ms. [redacted]'s claim for total disability beginning April 30, 2014. Since her policies were within the contestable period (the loss being claimed occurred within 1 year of their issue dates), our Claim Department began conducting a standard pre-existing condition investigation. However, after further review, our Claim Department noted that they previously conducted a pre-existing investigation under her prior claim. Since our company already had her medical information on file from the prior claim, the adjustor reviewed those medical records and processed her claim for benefits on September 9, 2014.
Since her Income Protector Policy has a 30-day elimination period, our Claim Department issued total disability benefits from May 30, 2014 to July 30, 2014. (Disability benefits were paid to July 30, 2014 because that is the date her doctor signed the claim form.) Our Claim Department provided a claim form with their September 9, 2014 benefit check so that she may have her doctor complete the form for additional disability benefit consideration. Upon receipt of additional disability verification from her doctor, our Claim Department will give further consideration to her claim.
While we trust that this letter satisfactorily responds to her inquiry, please extend our apologies to Ms. [redacted] for any concern or inconvenience she may have experienced as a result of this situation. If you have any questions, or if I can be of further assistance, please let me know.

Sincerely,
[redacted] Senior Coordinator
Combined Life Insurance Company of New York
Consumer Service Investigations
Direct: (XXX) XXX-XXXX
Toll Free: (XXX) XXX-XXXX / Ext XXXXX
FAX: (XXX) XXX-XXXX Case #XXXXXXX

My fiancé and I both took out insurance policies with Combined. His was for accidental coverage as well as mine which included emergencies resulting in overnight stays in the hospital. He sent in a claim after her spent time in the hospital and was constantly denied claiming he didn't provide enough information. He continued to comply with their requests for more documentation which clearly stated his emergency and stay at the hospital. Still, they kept sending denial letters. I signed up this summer for a policy that would cover me in case of a complicated pregnancy. The woman who sold us the policy stated many times that emergency induction would be covered. So a few weeks after my emergency induction, I filed my claim. Received a letter denying my claim asking for more documentation. I sent them at least 10 pages of documentation including the application signed by my OBGYN. I've called their office 6 times over the past several weeks and have received no call back. It's been almost 2 months since my initial claim was filed. My fiancé is a salesman for a different life insurance company and understands the ins and outs of a company like this. He is disgusted in the way this company has robbed us. Please don't waste your time or money this company is clearly a FRAUD.

I am tired of the constant arguing with the company to get a claim paid. Everything needs a Dr form completed. You just can't submit a copy of the services and what is paid. For continued claims for my son who has 2 medical diagnoses and continues to require ER or impatient hospitalization this can cost more for the claim do m to be completed than what they will reimbursement for. I am seriously consider dropping all my policies with them.

10 years of excellence in paying my claims totaling over $100,000 +. They don't need some stupid duck as a gimmick either. My only regret was NOT buying more coverage while I was still a healthy enough to qualify. Thank you Combined insurance company!

Initial Business Response /* (1000, 5, 2015/04/20) */
To: [redacted] Dispute Resolution Specialist
RE: Your Complaint #: XXXXXXXX
Consumer: [redacted]
Dear Ms. [redacted]
In accordance with HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal...

to protect all confidential policyholder health information, specifically regarding claims, while continuing to provide high quality service to our customers.
As the disclosure of Mr. [redacted]'s claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that our Claim Department has contacted Mr. [redacted] directly to discuss his claim and we have honored his request for cancellation of his policies.
If you have any questions, please do not hesitate to contact us.
Sincerely,
[redacted] L. [redacted]
Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
(direct line) X-XXX-XXX-XXXX
(toll free) X-XXX-XXX-XXXX Ext. XXXXX
(fax) X-XXX-XXX-XXXX

October 27, 2015
Revdex.com Serving Chicago & Northern Illinois
330 N Wabash Ave Suite 3120
Chicago IL 60611-7621
[redacted]
[redacted]
To whom it may concern:
Thank you for contacting us regarding the additional correspondence you received from the consumer, in reference to your Complaint Case [redacted] listed above.
We understand that the consumer indicated that she did not accept the response from the business and there was no response received. Our Claims department confirmed that the letter was mailed to [redacted] on October 16, 2015, and we regret to hear that it was not received. Today, another letter was mailed to [redacted] explaining what information is needed in order for us to review her claim for benefits. Due to HIPAA, we are unable to forward copies of these letters to your office without a HIPAA authorization from the insured.
Should you have any questions, or if we may be of further assistance, please let us know.
Sincerely,

[redacted]
[redacted]
[redacted]
[redacted]
[redacted]
[redacted]
[redacted]

Initial Business Response /* (1000, 5, 2015/01/30) */
January 30, 2015
[redacted]
Revdex.com
330 Lower Wabash Avenue
Chicago, IL 60611
Re: Your Case #XXXXXXXX
Dear Ms. [redacted]
This letter is being written in response to your letter of January 26, 2015.
In...

her statement to your office, Ms. [redacted] indicated that she made several attempts to cancel a policy with a monthly premium amount of $117.83, but that the advice she was given by our call center was to contact her bank to prevent the $117.83 payment from being collected. She then said that we split the payment and collected a partial payment of $75.83.
We investigated this matter and learned the following.
On January 9, 2015, Ms. [redacted] met with two of our agents. She applied for a SickPay Plus Policy with a monthly premium of $117.83 through agent [redacted] and an Accident and Sickness Protector Policy with a monthly premium of $75.83 through agent [redacted] Both agents met with her at the same time.
The majority of our applications are now completed electronically through iPads. When an application is completed, the agent simply uploads the application to our home office for immediate processing. However, technical difficulties prevented Mr. [redacted] from submitting the application for the SickPay Plus Policy. The software in his computer ultimately had to be reloaded. When the application software was reloaded, all of the data for the SickPay Plus Policy application was lost. As a result, no premium payment was ever collected for this policy. Mr. [redacted] told our office that when he went back to meet with Ms. [redacted] in order to complete a new application, she said that she had already cancelled the coverage and went with another company. For the record, Ms. [redacted] was able to successfully upload the application for the Accident and Sickness Protector Policy.
In view of the above, we did not split a premium payment and/or collect a partial payment. Instead, the $75.83 collection was the total premium amount for one of the two policies she applied for on January 9, 2015.
The main challenge associated with this situation is that we had no record of the SickPay Plus Policy. While Ms. [redacted] had paperwork associated with the policy in her possession, we had no official record of it on this end when she called to cancel it because the application was never submitted to our company (for the reason discussed above.) In the absence of documentation on our end, our call center recommended that she order a stop payment through her bank.
We note that a refund of the initial premium payment of $75.83 for her Accident and Sickness Protector Policy was processed and mailed to her on January 24, 2015. However, several days later, we note that we also mailed a letter to her to let her know that her bank did not honor our initial premium collection attempt. Based on this, it appears that the refund check was mailed to Ms. [redacted], in error. Kindly ask her to mail the check back to our company at:
Combined Insurance Company
PO Box 6703
Scranton, PA 18505-0703
Ms. [redacted] mentioned that we mailed her a premium notice where we requested $455.00. When the premium draft process is discontinued in the absence of a written request to cancel the process, a premium notice requesting a semi-annual payment is automatically generated and mailed. It was for this reason such a notice was mailed to her. She may simply disregard the notice at this point as the policy is no longer in force.
While we trust that the above explanation successfully addresses her inquiry, please ask Ms. [redacted] to accept our apologies for any concern or inconvenience she may have experienced as a result of the challenges she encountered when she attempted to cancel her coverage.
If you have any questions, please let me know.
Sincerely,
[redacted] Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
Direct: (XXX) XXX-XXXX
Toll Free: (XXX) XXX-XXXX / Ext XXXXX
FAX: (XXX) XXX-XXXX
Case #XXXXXXX

This company is misleading, manipulative and also has fraudulent practices. I sustained a back injury approximately a month ago, which has kept me from earning a gainful wage. According to my policy, I would be compensated for my injury for up to two months at the rate of a thousand dollars. Combined Insurance requested that I send supporting documents, therefore I faxed and uploaded the information that was required multiple times. I was then told that certain documents were needed by one representative and then another representative would state otherwise. I requested that I speak with my adjustor on several occasions but was denied and was only given his name. I am a full time licensed barber by occupation and therefore I am considered self-employed. With any back injury, you cannot stand for a prolonged period of time. As a professional barber, my occupation requires me to do so and also to perform other strenuous activities that a back injury doesn't allow. This was my first and last claim with Combined Insurance. I strongly feel that you do not screw over your loyal, paying customers.

Initial Business Response /* (1000, 5, 2015/10/14) */
To Whom It May Concern:
In accordance with our Privacy Pledge as well as HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential [redacted] information, specifically...

regarding claims, while continuing to provide high quality service to our customers.
As the disclosure of Mr.[redacted] claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that our Claim Manager has already spoken with Mr.[redacted] and Mr.[redacted] has further been contacted through the mail.
If you have any questions, or if we may be of further assistance, please do not hesitate to contact us.
Sincerely,
[redacted]
Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
(direct line) X-XXX-XXX-XXXX
(toll free) X-XXX-XXX-XXXX Ext. XXXXX
(fax) X-XXX-XXX-XXXX

Our records indicate that a voicemail message was left with the customer this afternoon.
If there are further questions, please let us know.
Thanks,
COMBINED INSURANCE COMPANY OF AMERICA

Initial Business Response /* (1000, 5, 2015/04/06) */
Dear Ms. [redacted]
Thank you for your correspondence regarding your Office's case #:XXXXXXXX.
Please be advised that due to HIPAA protected information, our Claims department responded directly to the consumer's concerns, as expressed...

in his complaint, on April 2, 2015.
If we can be of further assistance to you, please let us know.
Sincerely,
[redacted]
Combined Insurance Company of America
Consumer Service Investigations
(XXX)XXX-XXXX Direct
(XXX)XXX-XXXX Ext XXXXX Toll Free
(XXX)XXX-XXXX FAX
Case #XXXXXXX