Comstock Insurance Agencies, Inc.

dental insurance, [redacted] company was going to change dental insurance and I was right in the middle of major work half way throw and I talked the agent [redacted] if this would be any problem with my coverage I have now , she a sured me no it is the same plan, informed her I was right in the middle and she called boss and called me back said you will be covered.well we continued with the new dental insurance and I went back to my [redacted] office and I was told they will not be able to continue due to the new insurace doesn't cover any removal of prior teeth. And I explained this is what I was in the middle of for a brige to be put in. So I contacted her boss and he said he would get back to me , I tried calling her also she was on vaction now states there was nothing she could do. We would of not gone with this dental insurace if I could not continue my treatment I was doing. This is my 2nd coverage so my primary is mine they would pick the most of the bill. I do have my copies of the email when trying to solve this matter. so I have not been able to even use this new insurance even throw we pay every month to have it. I don't know where to go from here. I feel she told us what ever we wanted to hear to get the sale and for we can go with her insurance she was selling. Thank you for your time.Product_Or_Service: dental insuraceDesired Settlementi would like them to honor what their sales rep stated. I need to finish my work on my teeth. I would of been done if I would stayed with the [redacted] and not gone with [redacted]. Why would I have a dental plan I doesn't benfit me and pay every month into it. Business Response Contact Name and Title: [redacted]Contact Phone: [redacted]Contact Email: [redacted], as an agent of Comstock Insurance Agencies, Inc., became the agent on the group dental coverage for [redacted] ([redacted]'s [redacted]'s employer) on 9/1/12. The policy in force at the time [redacted] became the agent was written through [redacted] and expired on 10/1/12. [redacted] asked [redacted] to shop the renewal coverage with other carriers. [redacted] proposed coverage with [redacted] as an alternative to the [redacted] renewal effective 10/1/12. The proposed [redacted] policy was substantially similar to the expiring [redacted] policy and some of the coverage options were better with [redacted] than those provided by the [redacted] policy. Coverage for work related to previously removed teeth is similar in both policies (if the tooth is removed by the first prior carrier, related work is covered by the current carrier.) It turned out that the teeth in question had been originally removed prior to the original effective date of the [redacted] policy (the first prior carrier) so the work was not covered by [redacted] policy.[redacted] did everything possible to try to convince [redacted] to cover the work relating to the missing teeth, but the policy contract wording would not allow them to do so. [redacted] made no effort to 'sell' the [redacted] policy to [redacted] as (at least to our knowledge) neither she nor her [redacted] had any influence over the decision on which policy [redacted] would buy. [redacted] may have reassured [redacted] that the [redacted] policy would be similar to the [redacted] policy, and that work in progress is generally covered when you switch carriers, but an in-depth review of a specific procedure was not done.As the decision to change the group dental coverage from [redacted] to [redacted] was made by the management at [redacted], [redacted] did not have the option to continue the [redacted] policy. Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)[redacted] is a small company of under 10 employees in reno office . When change was being done I called and ask [redacted] one n only secretary [redacted] , which she gave me [redacted] number to make sure everything would stay the same. Which old coverage covers replacement of tooth . Which I did have mine removed to put in a bridge. What [redacted] should of done was check with my denist [redacted] office which I did give her all my paper work from [redacted] office . And again said yes I would be covered . Not after we went with them , thats when she tried get my claim worked on due to what she has said that everything would stay the same. When a small company like this ask you to shop around for better insurance the doesnt mean to find less coverage. I really fill [redacted] did do her job by not checking on the coverage we did have to what we were changing too.And influence on the decision from what [redacted] told me yes I let my [redacted] manager of this office in Reno that [redacted] stated it was the same due to thats what I was told. Employees were asked if they supoorted the change since it is a small office .I do not want this to happen to another person just for [redacted] number can go up. You messing with peoples life. So now i'm payimg for coverage every month that I will not be able to use that does not sound right.Thank you BB for all your time in this matter.Final Business Response [redacted] verified that the proposed dental coverage with [redacted] was at least as broad as the expiring coverage with [redacted] prior to presenting the proposal to [redacted]. Ongoing work is covered in general, but every insurance policy has some conditions and exclusions. Unfortunately, [redacted] had changed carriers twice since the teeth were removed and this resulted in the work falling subject to an exclusion. It is not feasible or appropriate for an insurance agent to contact group members' medical/dental providers and ask for detailed medical/dental history and ongoing treatment plans and then submit that information to a prospective company to see whether all potential claims would be covered. Even if detailed records and treatment plans are obtained, the prospective insurance companies will not agree to spend the considerable time & expense required to evaluate potential claims for individual members of a small group like this when they do not even know if they will be writing the policy. [redacted] provides secondary coverage to [redacted] that supplements payments made by her primary dental coverage. As much as we would like to get coverage for all [redacted]'s work, [redacted] has already declined to make an exception as it would be contrary to the policy contract. [redacted] can (and has) used her dental benefits with [redacted] for other procedures.Final Consumer Response (The consumer indicated he/she DID NOT accept the response from the business.)I understand the explanation but do not agree with their answer. It is not the consumer responsibility to know how to maneuver through the minefield of coverage when the insurance has changed hands.What should have happened is a letter to covered parties that were in the middle of procedures or treatment outlining the coverage sold and instructions on how we are to proceed with payment for [redacted] approved covered procedure. This should have been part of negotiations to protect us consumers in transition of procedures perfrmed and pre-approved.I am not negating that is not their responsibility to go to every insured individual. However, it was ans is there responsibility to contact the insured parties of work already approved for payment. I should notbe held responsible to pay for my denial bill that [redacted] already aproved payment and proceduresthat would be performed.I worked with them to resolved this issue and still am not happy with any response less thancompensation for money I had to pay after I was guaranteed coverage.