Myers-Stevens & Toohey & Co Inc

I'd be happy to contact Ms*** directly in order to ID her son and claim number so to be able to look into this further for her Due to privacy laws, we are not able to share any details concerning any student accident insurance claim filed with us through this forum

Revdex.comI was out of the country on 7/23/with no access to e-mail when notice of this complaint was sent.I'll contact the complainant today to see what his issues involved.I'll be back to him/you with a response shortly thereafter. thank you.*** ***

Re [redacted] Dear Revdex.comI did respond at length to the mom who made the complaint.  I'm not able to share the details of the response with your company due to claim privacy issues. However, know that I did explain to her that I'd reviewed the file in detail, why the claim denial was...

made and told her that based on the information contained in school records and medical records, the claim was correctly denied.As before, she was advised that if she doesn't agree with our determination and has additional information which she feels should be considered, she can submit it to us and the file will undergo a second, independent review.Based on our conversation, I believe she will be submitting additional documentation.If you have additional questions, feel free to contact me directly. [redacted]

Review: The company was paid per year for our grandson's 24 hour accident insurance. We received a letter from them, after a claim was filed regarding an accident during a school sport. They stated the injury was not covered. We never were told that this, or any other injury suffered through no fault of the injured party, was not covered. We fully expected this injury to be covered. It was an accident during a sport activity. We have never used this insurance before and have paid for 24 hour accident coverage many years. We thought we could feel more secure knowing that our grandson was covered 24 hours a day from accidents. They falsely took our money all these years.Desired Settlement: We want all medical bills paid by the company!

Business

Response:

Revdex.comI was out of the country on 7/23/15 with no access to e-mail when notice of this complaint was sent.I'll contact the complainant today to see what his issues involved.I'll be back to him/you with a response shortly thereafter. thank you.[redacted]

Review: We purchased tackle football insurance for our high school age son. He had an injury and we took him to the ER. [redacted] and [redacted] took forever to process the claim then every month or so we would get a letter stating they needed more info, yet the info they were inquiring about they had already been given on initial claim form but we resubmitted again and again. The last correspondence we received from the company was a request to contact the risk mgt person at the school district because the company claims that person did not return their calls. We called the district and they said they provided all needed info. Then a few months pass we get a past due notice from the hospital and a warning it will be turned into collections. The injury happened 9/2014 and now we are 7/2015 and they have still not paid the claim. The injury was covered by the policy we bought so there would NOT be a hold up! We have tried countless times to contact the company and no one will ever answer and if they do it is sent to a random voicemail and NO ONE HAS RETURNED OUR CALLS!! How can we fix this if they never call back or answer??? It seems this insurance is only interested in getting the money for the policy and NOT paying its claims!!! This is total fraud!Desired Settlement: I would like [redacted] and [redacted] to pay our claim. I would also like them to quit offering their insurance packages to schools. Parents pay for insurance to protect their children and this company is a scam preying on families. They need to stop giving the run around to medical facilities and customers! We paid nearly $400 for ZERO COVERAGE and now have an additional $800 now to pay for a medical bill that they failed to acknowledge in a timely manner.

Business

Response:

Re [redacted] Dear Revdex.comI did respond at length to the mom who made the complaint. I'm not able to share the details of the response with your company due to claim privacy issues. However, know that I did explain to her that I'd reviewed the file in detail, why the claim denial was made and told her that based on the information contained in school records and medical records, the claim was correctly denied.As before, she was advised that if she doesn't agree with our determination and has additional information which she feels should be considered, she can submit it to us and the file will undergo a second, independent review.Based on our conversation, I believe she will be submitting additional documentation.If you have additional questions, feel free to contact me directly. [redacted]

In my initial phone call with our "claims adjuster" I was told it takes an average of 10 days to review the claim and send it to the under-writers for approval. Over a month later, she scoffed and said "I never said that". No, I just pulled that sentence out of the air.... Anyhow. I submitted the claim form at the beginning of the month of March. Now July, MONTHS later, they send me a denial letter and right before the holiday too to boot so I can do nothing other than file online complaints with the California State Department of Insurance and the State Attorney General's office. and send them emails disputing their denial of our claim. They say no accident so no injury. Yet the kid was injured on a school field trip and came home injured and I had to pay hundreds of dollars out of my pocket to cover the costs of co-pay and portions not paid by the regular insurance. DO NOT trust this company as far as you can throw it!

My son injured his arm while playing water polo game at school in Fall 2013. He went through a fhysical therapy. I filed a claim... More then six month later received a letter stating that "... benefits for treatment that is due solely and directly to a specific accidental bodily injury that happens while at school ..." and "... the supporting medical documentation... does not indicate that the condition being treated was due to a specific accident ...". What?! How is that "not indicated"? Now I owe more then $1000 in medical bills. Now we are collecting documents to file an appeal...

DO NOT PURCHASE THIS INSURANCE! It's a scam!