Dean Swain Construction

[A default letter is provided here which indicates that the business has not responded to you directly If you wish, you may update it before sending it.] Revdex.com: At this time, I have not been contacted by Dean Swain Construction regarding complaint ID Regards, [redacted]

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that this proposed action would not resolve my complaint For your reference, details of the offer I reviewed appear below.I will go through their email by paragraph by paragraph.First Paragraph,"Azimuth has had several email correspondence with you in regards to the denial of those claims."There have been emails in which my denied claims were mentioned form you and only one of them answered the questions I askedThe one question answered was how to submit an appealThe other two emails did not address my questions at all which were "What information are you using from our records to come to your conclusion?" One of my biggest complaints is how I have to chase you down to get a response, weeks after I was told it would comeThis is not professional or acceptable.Third Paragraph,"The claims we received for you Mr [redacted] , noted in your medical records an ongoing problem over the course of years.I must point out that this condition was not noted on your application."I have had my insurance with you for TWO years, with no break in serviceThis is exactly what makes me think you have not paid any attention to or even read my complaints or questionsThe condition was not listed on my application because it did not exist years ago when I first got my insurance through you on FEB The problem occurred AFTER this per my medical records which I have already explained to you once in my initial appealFourth Paragraph,"With regards to Mrs [redacted] ’s claims, all of her claims were also related to a treatment for a condition not covered under the policy All of the procedures done were directly or indirectly treatments for this condition."Our medical records clearly indicate that my wife's chief complaint is not the one you are claiming the procedures are forThe procedures performed can be done for a myriad of reasons and you are picking one that best suits you, so you don't have to pay and not the reason they were actually performed forIn all of her claims there is one charge for $listed that relates to the not-covered conditionWe were aware of this and fully expected to pay itOur Doctor informed us that while they were looking into the chief complaint it was very simple for them to check this other thing as wellAgain we knew this would result in a $charge that would not be covered but we decided it was worth the $to take advantage of the opportunitySecondly during a phone conversation with your office after everything had been denied, I was told ever so rudely, that all the procedures my wife had done were only ever done for one purpose and that purpose was not covered, therefore the claims were deniedThis information is incorrect and can be easily confirmed where you will find many reasons to perform the procedures not relating to the one not covered conditionSecondly if your office has it in your system or has decided that these procedures are only done in regards to this one not covered condition, why did you pre-approve them? Either way this does not make sense and I'm confident that every medical professional I have spoke with has not lied to me and that if you were brought before the state insurance commissioners office you would be found at fault.Fifth Paragraph,"We are providing insurance for those individuals whom reside outside our their home country All of this is clearly provided from our website, brochures and policy wording." But no where are people informed of what this meansthat if they use your insurance, even though you are a US business and they are a US citizen and resident they will not be protected under US insurance laws, standards and regulationsSixth Paragraph,"It is unfortunate you do not feel as though you received quality service from Azimuth We have responded to your calls, emails and complaintsbased on our policies and procedures Should you have any additional questions or concerns, please contact us."In the latest email I received from you, you said..."Should you have any additional questions or concerns, please send your those to our Customer Service email box at [email protected] This will ensure all of your emails are responded to within business hours of our our guarantee."First this is hard to understand, but I take it you are saying that your policy is such that when I email this address someone will respond to me in 24hrThis is a great policy to have but this is a complete joke coming from your office nowAgain my major complaints are that you do not get back to me for days and weeks! SO if that is your policy you by no means have responded to my communications according to themPart of the very reason this is now happening through the Revdex.com is because you DO NOT do precisely that very thing This response addresses only one of my issues and that is the specific reason as to why my claims were denied, which as I suspected is still an insufficient answerEvery single other item has not been addressed including why no one has sent my doctor the needed paperwork.I have attached my records showing that in no way have they responded to me according to their policies Regards, [redacted]

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined that this proposed action would not resolve my complaint. For your reference, details of the offer I reviewed appear below.I have seen the records and so have the doctors that created them and none of us can see how you are coming to your conclusionsThat said, I understand you are going to have the final say in this mater because there is no one who can legally look into your decision process and determine if what you are doing is correctYou are unfortunately for me or anyone else like me, outside the law. But what I hope is revealing to everyone involved in this process or any one who looks into it in the future is how you have still not addressed all the other large and still pending customer service and administrative problemsThere has not been even the slightest acknowledgment of your failure to communicate to your own standards even though it's completely documentedNo acknowledgment or explanation for why when numerous people in your office said they would do something "Right away" it was still not done weeks later! As of this very moment there is still a doctor waiting for the paper you said would be faxed to them months ago, and have since told me you did itWhat I hope people gather from this is that professionalism, customer service and concern for paying customers are at the bottom of your priority list and keeping a tight fist on your money is at the topEven on the claims you have agreed to pay on on you have not done your job, you have not done what you said you would do and were paid to doYou have failed to handle my situation according to your own policiesI have been ignored and have been treated disrespectfullyI want an apology and explanation for your failures and a refund on my premiums because even aside from the denied claims, you have still not done the job I paid you to doYou have not upheld your side of the contract
Regards,
*** ***

Revdex.com:
At this time, I have not been contacted by Dean S*** Construction regarding complaint ID
Regards,
*** ***

[A default letter is provided here which indicates that the business has not responded to you directly.  If you wish, you may update it before sending it.]
Revdex.com:
At this time, I have not been contacted by Dean Swain Construction regarding complaint ID...

11764457.
Regards,
[redacted]

March 10, 2015 Dear Mr. [redacted]: We have received notice of your indifference with regards to your claims and the denial of those claims. Azimuth has had several email correspondence with you in regards to the denial of those claims.  An appeal wasreceived in our office December...

20, 2014 and it was determined on January 20,2015, all claims were denied properly.   We determine eligibility of each claim received by reviewing all information provided.  Along with the Claim Form andmedical records; past and current, we are able to make a determination is a claim is eligible in majority of the claimsreceived.  In some chases, we will send the file out for further review by a Doctor and/or Nurse Practitioner.  The claimson your behalf, we were able to make the determination without sending the file out for further review.  All of the necessaryinformation to determine if the claims were eligible was in the medical records.  With regards to Mrs. [redacted]’s claims, we didsend the file out for further review to determine eligibility.  With their review of the medical records, we determined the claims to be ineligible and were denied.The claims we received for you Mr. [redacted], noted in your medical records an ongoing problem over the course of 1.5 years.I must point out that this condition was not noted on your application.  If it had been noted at the time of application, we wouldhave put a medical rider on this condition excluding treatment for a number of months.  This exclusion would have been a requirementfor us to have approved your application. Conditions that are noted on the application and do not have a medical exclusion are coveredafter 24 months of continuous coverage up to $10,000 per Coverage Period.  Since this condition was not previously acknowledgedon your application we denied the claims as pre-existing. With regards to Mrs. [redacted]’s claims, all of her claims were also related to a treatment for a condition not covered under the policy.  All of the procedures done were directly or indirectly treatments for this condition.   An appeal was received on January 16, 2015 for Mrs. [redacted]’s ddenied claims and we determined on February 1, 2015 the claims to be ineligible.To address the legality of our business claim.  Azimuth Risk Solutions, LLC is in the international insurance industry.  We are a Managing Agencyfor our insurer, Lloyd's London and the Scheme Administrator for the Meridian Series.  We are providing insurance for those individuals whom resideoutside our their home country.  All of this is clearly provided from our website, brochures and policy wording.It is unfortunate you do not feel as though you received quality service from Azimuth.  We have responded to your calls, emails and complaintsbased on our policies and procedures.  Should you have any additional questions or concerns, please contact us.  Should you have any additional questions or concerns, pleasecontact me. Sincerely  Chantel [redacted]VP OperationsAzimuth Risk Solutions. LLC

Mr. [redacted]Please contact your providers and request a copy of the medical records that they provided us.  As previously stated our determination was made based on the medical records, claim form, diagnosis and procedure codes.  We will not discuss your or your spouses medical history in a complaint email.  We have addressed your question several times, our decision was made based on our policy guidelines, medical records provided by the hospital and or physicans, the claim form, diagnosis and procedure codes.  Requesting payment for claims that were authorized is not a guarantee of benefits or payment.  This statement is provided to all providers and members when calling in for authorization.  Prior authorization will guarantee there will not be a reduction in benefits for any eligible medical expense.  Eligibility will need to be determined once the medical records, claim form, diagnosis and procedure codes are received.  We understand you are not happy with the decision to deny your claims and appeal.  Unfortunately we will not overturn our previous decisions and pay on claims that are not eligible based on the policy guidelines.SincerelyAzimuth Risk Solutions, LLC

Revdex.com:I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this proposed action would not resolve my complaint.  For your reference, details of the offer I reviewed appear below.I will go through their email by paragraph by paragraph.First Paragraph,"Azimuth has had several email correspondence with you in regards to the denial of those claims."There have been 3 emails in which my denied claims were mentioned form you and only one of them answered the questions I asked. The one question answered was how to submit an appeal. The other two emails did not address my questions at all which were "What information are you using from our records to come to your conclusion?" One of my biggest complaints is how I have to chase you down to get a response, weeks after I was told it would come. This is not professional or acceptable.Third Paragraph,"The claims we received for you Mr. [redacted], noted in your medical records an ongoing problem over the course of 1.5 years.I must point out that this condition was not noted on your application."I have had my insurance with you for TWO years, with no break in service. This is exactly what makes me think you have not paid any attention to or even read my complaints or questions. The condition was not listed on my application because it did not exist 2 years ago when I first got my insurance through you on FEB 13 2013. The problem occurred AFTER this per my medical records which I have already explained to you once in my initial appeal. Fourth Paragraph,"With regards to Mrs. [redacted]’s claims, all of her claims were also related to a treatment for a condition not covered under the policy.  All of the procedures done were directly or indirectly treatments for this condition."Our medical records clearly indicate that my wife's chief complaint is not the one you are claiming the procedures are for. The procedures performed can be done for a myriad of reasons and you are picking one that best suits you, so you don't have to pay and not the reason they were actually performed for. In all of her claims there is one charge for $200 listed that relates to the not-covered condition. We were aware of this and fully expected to pay it. Our Doctor informed us that while they were looking into the chief complaint it was very simple for them to check this other thing as well. Again we knew this would result in a $200 charge that would not be covered but we decided it was worth the $200 to take advantage of the opportunity. Secondly during a phone conversation with your office after everything had been denied, I was told ever so rudely, that all the procedures my wife had done were only ever done for one purpose and that purpose was not covered, therefore the claims were denied. This information is incorrect and can be easily confirmed where you will find many reasons to perform the procedures not relating to the one not covered condition. Secondly if your office has it in your system or has decided that these procedures are only done in regards to this one not covered condition, why did you pre-approve them? Either way this does not make sense and I'm confident that every medical professional I have spoke with has not lied to me and that if you were brought before the state insurance commissioners office you would be found at fault.Fifth Paragraph,"We are providing insurance for those individuals whom reside outside our their home country.  All of this is clearly provided from our website, brochures and policy wording." But no where are people informed of what this means.... that if they use your insurance, even though you are a US business and they are a US citizen and resident they will not be protected under US insurance laws, standards and regulations. Sixth Paragraph,"It is unfortunate you do not feel as though you received quality service from Azimuth.  We have responded to your calls, emails and complaintsbased on our policies and procedures.  Should you have any additional questions or concerns, please contact us."In the latest email I received from you, you said..."Should you have any additional questions or concerns, please send your those to our Customer Service email box at [email protected].  This will ensure all of your emails are responded to within 24 business hours of our our guarantee."First this is hard to understand, but I take it you are saying that your policy is such that when I email this address someone will respond to me in 24hr. This is a great policy to have but this is a complete joke coming from your office now. Again my major complaints are that you do not get back to me for days and weeks! SO if that is your policy you by no means have responded to my communications according to them. Part of the very reason this is now happening through the Revdex.com is because you DO NOT do precisely that very thing.   This response addresses only one of my issues and that is the specific reason as to why my claims were denied, which as I suspected is still an insufficient answer. Every single other item has not been addressed including why no one has sent my doctor the needed paperwork.I have attached my records showing that in no way have they responded to me according to their policies.  
Regards,
[redacted]

Review: Swain Construction was hire to perform repair to my roof. Repair leaks and paint the roof.All of the outlined work was not done, shoddy workmanship on what was done and roof is leaking worse than before. It has caused additional damage to the interior of the home. [redacted] did come out to look at the roof when called and said he would be back to make repairs. After not coming for several weeks with numerous excuses regarding his broken down truck, he delivered a ladder and a bucket of paint to the house claiming to return the next day. He has never come back. He has stopped respond to calls or texts. I have texts from him stating he was coming don't worry etc.This could be a health issue due to mold I can't see as a result of the leaking roof.This guy needs to go to jail !Desired Settlement: I do not want Swain Construction back on my property. I want the roof repaired properly and any other damage caused by the leaks, by a reputable contractor at his expense.