Partners Benefit Group

We are an Insurance Agency for all the major carriers in the marketplace. Of course we never receive premium payments from anyone. The employer would collect and pay the premiums directly to the carrier. This policy is written by Assurant Health and the claims are
process by Allied. This is a group policy written for *** ***. According to our information we received a call on February 25, that some claims were being denied for three dates of service, We contacted the carrier and was informed that this diagnosis was not a covered benefit in this policy. We have asked for them to review the claims and verify that all medical codes were properly used. We are waiting to hear from the carriers.
Mrs*** informed us that she was contacting Revdex.com. It has only been two weeks since we became aware of the issue and are still working to get the claims resolved. There is nothing else we can do except continue to work with the carrier and try to get them to pay the claim. If the employer did not purchase a policy that covers the issues for the *** child, that would be an issue they need to handle with the employer
Please let us know if we can answer any other questions

[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 ***, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved
Regards,
*** ***

This is not our call to pay the claim. We are only the marketing agent for Assurant. It is the carrier's call to determine whether the claim is covered under their policy. As I stated previously, we are trying to get the claim paid, but we do not have the authority to say yes or no. 
 
She should be complaining about the Insurance Carrier instead of the agent.

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.
[Provide details of why you are not satisfied with this resolution.]
Regards,
[redacted]
 
 The company has sat on this complaint for 2 weeks and have not made any sincere efforts to resolve this matter. If the policy clearly states the diagnosis is not covered as Allied is stating, I don't understand what claryfications need to be made. It's a yes or no answer.