GeoBlue

For my trip to Scandinavia, I purchase a trip only insurance policy which included $500 total, $100/per item lost/stolen item coverage. While in Sweden, my suitcase was stolen and the tour company (***) filed a report with the Tour Company, the Hotel and the local Police department. On returning to the states, I filed a claim with the insurance company. I have now received my second denial of claim from the insurance agency, this time because I have no receipts for the items lost/stolen (we are talking suitcase, cloths, shoes, electric toothbrush, toiletries, etc. Thinks that people do not keep receipts for). The first denial was noted as not providing medical records, as if they hadn’t even bothered to read the claim. I did provide them with the police report and report from the tour company ***, as well as a break-down of what items was in the suitcase, including prices.

I purchased travel insurance for my family’s trip to Cancun in March 2018. While in Cancun we went to a Parker p***. My husband has a heart condition and was resting while he was doing so someone stole his beach bag. His cell phone, clothes, and Some tolitreies were in the bag. We looked all over the park, asked several employees of the park, used the *** lost app, reported to their security. No one had the phone. We loaded the family back on the bus back to our resort that was close to 2 hours away. I had no phone service in Mexico but I filed a claim through email with GeoBlue. I also emailed X everyday to see if someone turned in the phone. Our last day in Mexico the water park thought they may have found our phone. We spent $200 on a taxi to drive of to the water park but the phone was not ours. We did not go to the police as we were in a foreign county. GeoBlue wanted receipts for all items that we purchased. I gave them copies except for the cell phone which has not been replaced. We can not afford to replace the cell phone. We did buy all other items. We even turned into our home insurance but our deductible is $1000.00. I paid my preumim now I should be paid for the claim I filed.

I contracted for travel Health Insurance with GEOBLUE several months ago. I could not get customer service to make a medical appointment overseas in accordance with their policy without "proving" that I have medical insurance in the United States. I requested an appointment online - it is suppose to be fast and convenient. 5 days later they requested proof of my GEOBLUE insurance. I emailed it and they replied that they wanted proof of my US domestic health insurance plan. They asked for a medical insurance card that they already have on file. I provided ALL of this information before contracting with this scam company. They have all of the information on file. They request this information as a stalling tactic and as a disincentive to seek medical care.
After this poor customer service I decided to Cancel the travel insurance. GeoBlue customer service said I CANNOT cancel travel insurance unless I send them proof of a return ticket to the United States. This CANNOT be a requirement to cancel travel insurance. It is on its face absurd. Calls to customer service were fruitless. If you do not select choices from the automated menu that do not correspond to your problem the system HANGS UP ON YOU. AWFUL company. I want to cancel service with them immediately without conditions and I want a refund of the money I have paid for services they are unwilling to provide.

I am a teacher, and every year I take a group of high school students on a 6 day trip to Costa Rica. We have used Geoblue as our health insurance provider for the last few years, though we have never had to use their services until this year.

On this year's trip, we were flying back from San Jose to Houston, when one of my students passed out and then vomited in the middle of the plane ride. When we got to the ground I took her to the hospital. I called Geoblue in order to get help reorganizing the travel plans for our group as they were messed up by our visit to the hospital. When I contacted Geoblue, they were both unhelpful and rude. I spoke with a customer service representative who refused to authorize any claim I made because we "were no longer in a foreign country," despite the fact that we were not yet within the United States and our coverage provided up to $500 for events that caused interruptions in travel. The customer service representative refused to acknowledge this, and then refused to connect me with her supervisor. Though I was angry, I still left my information for the supervisor to call me back, which never occurred. In my opinion this was not only a breach of contract, as we were not within the United States, but also an example of terrible customer service that put myself and my student in harms way. I will never be using Geoblue again, though I plan to continue taking students out of the country for years to come.

March 14, 2016Dear [redacted]:This is in response to your correspondence of March 8, 2016 relative to the referenced file.As outlined in our correspondence of February 26, 2016, [redacted] was covered under the GeoBlue Voyager Choice plan from December 25, 2015 until January 5, 2016. In order to obtain coverage, the name of each individual to be covered must be listed as well as their date of birth. The only information provided at time of application was for [redacted].In his response to the Bureau, [redacted] clearly admitted that he did not list his wife as a co-traveler, Had he done so, his assumption that the premium for coverage would have taken into account the additional traveler is correct. Since [redacted] was not covered under the policy, claims submitted for [redacted] are not covered.Claim [redacted] for [redacted], originally denied due to a key error as outside the coverage period, was reprocessed and check #[redacted] was issued on March 7, 2016 in the amount of $50.00.As previously explained, we are unable to reimburse [redacted]'s premiums as he did incur claims which have been paid based on the terms of the policy. Premium paid for the policy was $50.40; to date claims totaling $108.07 have been paid.We trust the above answers all points raised, however, should you have any additional questions or require additional information please do not hesitate to contact our office.Sincerely,Karen M.Administrative Appeals Department

February 20, 2015Dear [redacted]:
Please accept our response to complaint ID [redacted].
The customer has two issues with the...

service provided by our company:
1) A guarantee of payment was not extended for care
2) Payment for the submitted claims
In response to the first issue: It should be noted that given the initial urgency of the situation, a Guarantee of Payment (GOP) was issued for a three day stay in the hospital even though all required documentation for the member in need of care had not been submitted to us. When the extension was requested we requested the proof of credible coverage which should have been obtained before the first GOP was issued and because it was not provided, we were unable to provide an extension for the guarantee.In response to the second issue: The claims submitted were expedited and went into processing almost immediately. The claims he sent were dated from 1/28/15 - 2/4/15 and all were paid by 2/9/15.
Additional steps were taken to accommodate the customer because when he submitted the claims, he did not indicate that the wanted to be paid electronically. He then contacted us on 2/18/15 at 6:43 PM and said he wanted to be paid electronically and though the check had already been mailed, we agreed to and issued the electronic payment.
At this time, all claims have been paid,
Due to the importance of protecting private health information, we will need the customer to sign a HIPAA release before providing any additional information. If you require further documentation including timelines and protocols followed, please let me know and we will help facilitate getting that release.
We are very sorry that the customer had a negative experience, but we did pay benefits according to the certificate of insurance and protocols. We even went beyond our own protocols to accommodate the customer.
Sincerely,Moira B

[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.]
Revdex.com:
I have reviewed the response made by the business in reference to complaint ID [redacted], and find that this response is acceptable to me. 
Thank you,
[redacted]

April 10, 2015
Dear [redacted]:
This is in response to your inquiry of March 30, 2015 regarding the captioned case.This member was effective with GeoBlue as of May 1, 2014 through March 31, 2015. On March 13, 2015 we received correspondence from the member's broker on the...

member's behalf, requesting a termination of the policy effective March 13, 2015.On March 15, 2015 the GeoBlue Enrollment Department responded and advised that coverage would be terminated as of March 31, 2015, which represented the end of the last period for which premium payment had been received.
The March 31, 2015 termination date was based on the following provision in the member's Certificate of Coverage:How Coverage Ends The benefits provided by this Certificate terminate at the end of the current Period of Coverage. At the beginning of the next Period of Coverage you may re-apply for coverage. Any re-application is subject to submission of a properly completed application to the Insurer, the Insurer's approval of that application, and payment of the applicable premium to the Insurer by the Eligible Participant. Premiums will be based upon the attained age of the Covered Person at the beginning of the Period of Coverage
Insured Participants
The Insured Participant's coverage ends without notice from the Insurer on the earlier of:1. the last day of the month after the date the Insured Participant no longer meets the definition of an Eligible Participant,2. the end of the last period for which premium payment has been made to the Insurer,3, the date the Policy terminates, 4. the end of any Period of Coverage;5. the date of fraud or misrepresentation of a material fact by the Insured Participant, except as indicated in the Time Limit on
Certain Defenses provision.
On March 15, 2015, the member contacted our office directly requesting the termination date be changed from March 31, 2015 to March 13, 2015. On March 19, 2015 he was advised that we are unable to reimburse partial months. The member responded indicating that his new company plan does not permit him to have their plan while also being covered under another plan. Based on this, his request was reviewed by the GeoBlue Management team and it was determined on March 27, 2015 that an exception would be made and the option of back dating the cancellation to February 28, 2015 was made to the member which he accepted.
On March 30, 2015, the member was sent confirmation that coverage was terminated as of February 28, 2015 and that he credit card was refunded the full monthly premium for March 2015.
We are very sorry that the member had a negative experience, but we did follow the procedures set forth in the certificate of insurance and protocols. We even went beyond our own protocols to accommodate the member.
Sincerely,
Michelle C
Administrative Appeals Department

January 26, 2018Dear [redacted]:This is in reference to the Bureau’s inquiry on behalf of [redacted] dated January 18, 2018.According to our records this family was covered under the [redacted] Group Plan as follows:[redacted] and Children from 8/15/17 – 1/14/18 [redacted] was added to the policy as...

the spouse effective 11/13/17 – 1/12/2018We do have record of [redacted] contacting our office requesting cancellation of his coverage on December 20, 2017. Unfortunately, our customer service representative failed to forward the request to the appropriate department.We have verified that no claims have been presented for [redacted] and are therefore willing to refund the premium paid for his spousal coverage. To do so however, we need [redacted] to advise his mailing address as the only address we have on file is NY and he appears to be requesting that the refund check be sent to South Korea. Once the address is provided, the refund check will be promptly issued.We are very sorry that the member had a negative service experience. Upon review of the above, please do not hesitate me with any additional questions.Sincerely,Karen MClaims Director

August 22, 2016Dear [redacted];This is in response to your correspondence of July 22, 2016 relative to the referenced file.GeoBlue regrets that our member has been experiencing difficulty with getting these claims paid. It is our intent to provide quality service to all of our members.According to...

our records, [redacted] is not covered for maternity benefits for dates of service April 8, 2015-April 21, 2015.The policy under which the Song family is covered contains in part, the following provisions:VI. Exclusions and Limitations: What the Plan does not pay for Excluded Services:The Plan does not provide any benefits for:Services related to pregnancy or maternity care other than for complications of pregnancy that may arise during a Trip Coverage Period.The four of the claims received for Perian Song are ineligible for benefits under the above listed plan exclusion. This is clearly outlined in the Inember's certificate of coverage. Unfortunately, there was some confusion as the pre-existing exclusion was incorrectly citied on the original claim denial. Regardless, Maternity is not a covered benefit under the members' Business Traveler policy except for complications as stated in their Certificate of Coverage, Therefore, no benefits are due for these services.If you have any questions, or require any further information, please feel free to contact me.Thanks,Bob L.Executive Inquiries

This is in response to your inquiry of August 24, 2017 regarding the captioned insured’s Complaint. According to the information provided, Mrs. [redacted] was admitted to a hospital in Valencia, Spain from 3/17/17 – 4/4/17 for which she has not yet received payment.According to our records, Mrs. [redacted] is...

covered under a BlueCross Blue Shield of Tennessee policy which includes coverage for an injury or sickness incurred outside of the United States as part of the BCBS Global Core Program.GeoBlue, as the BCBS Global Core medical assistance vendor, provides administrative services for the BCBS Global Core Program, and as such, receives and codes all international claims which are then transmitted to the member’s local Blue Plan for adjudication of benefits.We have reviewed all calls and claims received for Mrs. [redacted] and find the following:• Our Claim 1241374 received on May 3, 2017 from [redacted], was transmitted to the Local Blue Plan on May 25, 2017. In order to determine benefits, the Local Blue Plan requested medical records and upon receipt, adjudicated the claim on June 5, 2017, with the charge applied to the member’s policy deductible.• In addition to the above claim, we have identified that GeoBlue did receive a bill from the [redacted] for the March 17, 2017 admission in the amount of 11,418.32 Euro. However, the facility sent the bill directly to our Global Health & Safety department with whom they had been working to coordinate an approval of the hospital admission. This billing was inadvertently not forwarded to Claims. This bill was processed today via Claim [redacted] and will be transmitted to the Local Blue Plan for their determination. Generally, the process can take up to 30 days, however, we will contact the Local Blue Plan and request that they handle the claim on a priority basis. Once the claim has been adjudicated by Tennessee, we will send you an update.Should you have any questions on the above, please do not hesitate to contact our office.Sincerely,Karen M[redacted]Karen M[redacted] GeoBlue Claims Director

This is unfair. Please help me.

[Personal information]

Name: ***
Date of birth: Aug. 30, 1976
Case: ref:_***:ref

[How the incident happened]
I sent a check to buy my insurance on Nov 6th.
The insurance period is Nov. 13th- Jan. 12th.
But GeoBlue did not accept the check, so I cannot buy the GeoBlue insurance.
So I bought another one.
Suddenly, GeoBlue accept the check on Dec. 19th.
This time was more than half passed of the insurance period.