Delta Dental of Wisconsin

This insurance is "[redacted]" don't waste your money!! They make you have a 1 year contract before you can cancel and a 6 month waiting period to cover HALF for procedures. Not to mention my local dentist office says the insurance isn't covering things they should be so I'm paying this [redacted] company and then paying my local office around the same amount! Beyond [redacted] that I wasted my time and money on this DELTA DENTAL WI!

Review: Business has agreed to provide dental insurance, which I pay premiums. Dentist insisted I receive two crowns due to worn fillings and hairline fractures. Put off for a year, then agreed to have the work done. Dentist found decay under the fillings during the crown procedure. Delta Dental refuses to pay their agreed share per the terms of our plan and has said 4 consultants have reviewed the work.Desired Settlement: Pay the claim per the terms of my policy with the Delta, approximately $1,200.

Business

Response:

Delta

Dental had four different dental consultants review the documentation and

x-rays provided by Mr. [redacted]’s dental office. All four consultants agree

these teeth do not meet the criteria for crowns.The

dental plan document states that “Crowns, inlays, or onlays are provided when

teeth are broken down by dental decay or accidental injury and may no longer be

restored adequately with a filling material.” Crowns may be recommended

by a dentist for many reasons, not all of which are covered by the dental

plan. Benefit for crowns is only available when a tooth is broken down by

dental decay or accidental injury to the point where it cannot be restored with

a filling. Some dental offices recommend crowns on teeth with

non-symptomatic fracture lines or to prevent future restorative care; however

benefit is not available for crowns done for those reasons.Treatment

decisions are between a dentist and a patient. The benefits available on

a dental plan should not be the main factor in deciding what treatment is

appropriate. Delta Dental recommends a predetermination for all major

restorative work, because it is upsetting to be caught off guard with a large

out-of-pocket expense.Mr.

[redacted]’s claim was processed in accordance with the contractual benefits

available under the dental plan.Tell us why here...

Review: I contacted Delta Dental to cancel my service because I had not used it and at the moment could not afford it.. They still went ahead and deducted 116$ from my account. Which in turn overdrafted my account. I receieved one email from them stating I need to tell why I was canceling my service. I let them know why and never received an email back. Emailed 2 more times and also never received a response. I called the 800 number and spoke to a lady named [redacted] who was very rude and very unprofessional. She stated there was nothing she could do for me but file n appeal with her supervisor and hung up on me. I am very dissatisfied! I basically am paying for something I can not afford and have not used.Desired Settlement: I would like to have my service cancelled. Also to receive my 116$ dollars back and the 35$ overdraft fee they caused on my account.

Business

Response:

Mr. [redacted] purchased the dental plan online effective 5/1/2014. The policy contract states the contract is for a one year period. Mr. [redacted] did not experience a qualifying event that would allow the early termination of the contract. We have agreed to allow the mid-contact termination effective 6/30/2014. July premium will be refunded.

Best of the best in Dental service. This is the first time I am getting from USA. I had been to many dental places in USA for last 10 years.

Delta Dental is very genuine and reasonable billing compared to other providers.

Review: I applied for dental insurance until December of 2015. I was sent an application for dental insurance with Delta

Dental. I was informed that if I did not submit the application the dental insurance would discontinue. The dental insurance was renewed anyway. I need a higher level of dental insurance from Delta Dental but they will not change the insurance. I am paying for insurance which does not cover root canals or bridge work which is the kind of dental insurance I need. I just want them to re-quote me for dental insurance that covers root canals and bridge work. At the present time they have me stuck in dental insurance which does not cover the dental work I need. I am stuck on this policy for a year but I need it changed to cover root canals and bridge work.Desired Settlement: Change the current policy to one which covers root canals and bridge work.

Business

Response:

The terms of the policy state it is a 12-month contract that runs through December 31, 2016.

Review: Complaint Type: Consumer to Business Complaint

Nature of complaint: Contract Issues

Problem description:

I signed up for a '1-year' contract with delta dental only to discover that delta has continued to charge me after 1 year (taking payments directly from my bank account). They say I am obligated to continue paying them for another year because of a sneaky clause in the contract regarding automatic renewal, which I did not agree to. No one had mentioned the existence of an auto-renewal clause verbally; I received NO notification/warning prior to or at the time of auto-renewal that this was going to happen. When I called and spoke with a rep they told me I could send a email requesting the immediate cancellation of my policy. I sent this email only to received a letter back saying they would not cancel, even though I did not want to renew and will not even be in the county for the next 9 months. This clearly is a deliberate attempt to trick people and to continue taking their money after they no longer desire services and has no place in an ethical business practice. The fact that such a stunt is being pulled in a healthcare related field is very shameful.Desired Settlement: Refund of June, July and August 2015 payments and immediate cancellation of policy AND to get rid of this deceitful ploy before others get taken advantage of.

Business

Response:

Delta Dental of Wisconsin is a claims administrator for the individual policieswritten by Delta Dental of Virginia. Delta Dental has record of several callsfrom [redacted] requesting cancellation of his policy. He was unaware ofthe automatic renewal. As a courtesy, the termination date has been changed toMay 1, 2015 and his premium refunded.

Consumer

Response:

[A default letter is provided here which indicates your acceptance of the business's response. If you wish, you may update it before sending it.]

I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this resolution is satisfactory to me.

Regards,

Review: I CALLED DELTA DENTAL THIRD WEEK OF AUGUST 2014 TO CANCEL MY DENTAL PLAN AND WAS TOLD COULD NOT CANCEL DUE TO HAD BEEN RENEWED FOR ANOTHER YEAR IN JUNE 2014. FIRST OF ALL WHEN PLAN TAKEN OUT FIRST TIME WAS NOT TOLD IT WAS FOR A YEAR PLAN. I TRIED TO EXPLAIN TO COMPANY I WAS NOT NOTIFIED OF THEM RENEWING MY POLICY SINCE I KNEW I COULD NO LONGER AFFORD POLICY DUE TO RETIRING. THEY DID NOT EXPLAIN WHY I WAS NOT NOTIFIED BUT THEY WERE REALLY QUICK TO SEND ME LETTER SAYING I WAS RENEWED AFTER I SENT THEM LETTER TO CANCEL AS INSTRUCTED. THE LETTER STATED I WOULD BE CANCEL EFFECTIVE 05/31/15.Desired Settlement: I WANT MY PLAN CANCEL NOW CAN NO LONGER PAY

Business

Response:

The terms of Ms. [redacted]'s policy clearly state that it is a one-year contract with automatic renewal. At Ms. [redacted]'s request, her policy is being cancelled mid-term, effective September 30, 2014. We believe that this resolution is satisfactory to Ms. [redacted] and this issue is closed.

Review: I issued a post dated check for one year,knowing that the stubs that were attached to the packet they sent me, was asking for a post dated check to be issued the whole year as it was indicated to on the stubs.The packet they sent has no information as to how payment would be process using the monthly stubs so I sent a stale or post dated check with all the stubs and information which they all deposited at the same time causing me to pay overdraft and transfer money to my checking account which shouldn't be done. In their FAQ portion on their website they even mentioned "When you complete your online application, you may select the payment option that works best for you. We offer two convenient ways to make your payment online: EFT (Electronic Fund Transfer) from your bank account or Credit Card. We also accept check payments with paper applications. You must pay a full year’s premium if paying by check."This is the reason why I issued a post dated check for a year.Desired Settlement: Refund the amount for the month of January to November 2016 amounting to $1,726.78 and give 2 months free dental coverage for the inconvenience that we experienced,continue to have dental coverage for the same amount even when dropped as we are past the health care reform deadline.

Business

Response:

Delta Dental will wait to hear what action will be taken by [redacted]'s bank.Thank you.

Consumer

Response:

I have reviewed the response made by the business in reference to complaint ID [redacted], and have determined that this does not resolve my complaint. For your reference, details of the offer I reviewed appear below.

To whom it may concern,On December 30, 2015 my wife called the customer service number asking for explanation about the deposited checks and if they can just cancel our application and get our refund back,the customer representative said that there is no way they can return the money they deposited not unless we can arrange it with the bank to stop payment.I went to a Chase Bank close to me at around12:00(845 Franklin Lakes Rd.Franklin Lakes NJ 07417 Tel.####-###-####) and spoke to a [redacted] Officer/Relationship banker about the incident and tried to fill up a certain form to halt all deposits,Mr. [redacted] called the same number listed to speak to a representative and confirm what happened to process my claim.Waited an hour an nobody was able to pick up the phone which was prompted to be answeredin 21 minutes.The banker informed me that they cannot process the claim not unless he speaks to a representative from DELTA dental.I called my wife and ask her to call DELTA again and see if she can ask them to cancel it again but they said that they could not cancel it since we applied in the Healthcare.gov website to cancel our application.DELTA was quick to get our money but was slow to answer our queries when needed.Their instructions on their billing needs to be investigated as there is not enough details to guide the consumer.I would pursue this claim and call FOX 5 News or any other TV stations if this would not be resolvedin 2 weeks,you have swept my checking account penalizing me to pay fees that should not be charged to me.The checks I issued all have post-dated checks and should have been respected by DELTA that it be remitted as indicated,I have all duplicates to prove my claim including the transaction in the bank as stated.