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 Regards, [redacted] response 2/24/15HCC has a very well documented internet history using excuses not to pay on thier policy HCC has deemed my condition: pre-existing,,...when A]--the top expert in connectcut,Dr Wu,liver expert [published] Uconn john dempsey , still has no exact diagnosis for me ,the known is its a liver problem,I asked him about pre-existing,,,he stated his job is not for insurance companies,his job is to fix meB]I never in my entire life had an esophageal bleed,this is what I was hopitalized for , C] HCC has also deemed my hospital stay non emergency ,even though I almost died , D]HCC insisted follow up procedures be done at a hospital facility,instead of outpatient,the hospital was much more expensive,done only at HCC demands,and they still havent paid.significantly increasing costsE]HCC-pre approved EGD services for doctors offices,that they now are not payingF]Anthem,the company I replaced HCC with when I learned how bad HCC is,has paid every claim submitted,some are days literally away from cliams HCC hasnt paid,and some are claims HCC did not pay [i had double coverage 11/2014]G] to date HCC has not paid one dime,on all the claims they have recieved,using every excuse that can be thought of,non emergency-pre-existing [thier favorite] lack of records , lack of documents,lack of additional steps takenH] I personally provided my med records to HCC via registered mail,on burned CD"s,hence,lack of records,and no pre-existing esophageal bleed ever,is well documented,I was taken by ambulance to sharon hospital,in ICU for days,this was an emegency,regardless of HCC opinion of the matter...near death..to me , is an emergency Overall,HCC has a reputation of using excuses,,,coding issues , and any possible method not to pay , my only truly pre-existing condition is I was born,I have elevated all HCC claims to appeal level , I will progres to level , then level with the state of CT insurance commision , if resolve still cannot be met,litigation will definitely be opened against HCC by me,Lawyers,,,tend to resolve things,the list of complainants against CC is huge,there are entire websites about them and HCC techniques used not to pay claims...HCC needs to grasp,this IS NOT going awayAny simple internet search will find more cases than countable..of folks having problems with HCC paying claimsto resolve this, HCC needs to pay the claims sent to it regarding this matter,if this reaches litigation,damages will be sought [redacted] 2/24/
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 This company refuses to communicate on any human level I understand the terms of my insurance deductible, I am not disputing that My issue is that the policy advertises a dollar copay at urgent care facilities However when the customer actually goes to the urgent care facility the insurance is not accepted If they do not have a network of providers within my area they should not be allowed to sell me a policy One would think that if this was not a scam they would have provided me with information on where I should have gone instead of the ER A legitimate company would want to clear up this issue in hopes of future repeat business I am willing to settle for refund of my premium which is far less than my hospital bill I guess they need this $more than I do 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 Pre-Authorization from HCC Insurance letter dated March 12, approves for Certificate number [redacted] and Authorization number [redacted] for procedure Uterine Fibroid (diagnostic code 218.9) and Dysmenorrhea (625.3.) on May 16th During authorization process HCC was well aware this was for Uterine Fibroid and gave authorization for the procedure that came out as Uterine Fibroid (diagnostic code 218.9) and Dysmenorrhea (625.3.) which is exactly what they approved If this diagnosis was not covered under the policy then why/how could they authorize and not let anyone know (not even the patient) they were approving what they now claim is not covered on their policy Regards, [redacted]
Ms [redacted] was covered under out Atlas America policy which is issued on a non-admitted basis to the Atlas/International Citizen Group Insurance Trust out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administrator HCCMIS has received claims from Ms [redacted] , however, the Claimant's Statement and Authorization forms that have been received by HCCMIS have either been incomplete or not signed by Ms [redacted] Forms submitted by [redacted] cannot be accepted since they were not appropriately signed by Ms [redacted] The Claimant's Statement and Authorization form may be completed and signed • electronically via the ClientZone by visiting www.hccmis.comUntil the Claimant's Statement and Authorization form has been full completed and appropriately signed, HCCMIS is unable to reopen Ms [redacted] 's claims I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me know Sincerely, [redacted] HCC Medical Insurance Services%3%
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 In the very short message from HCC insurance, it was only mentioned they "are reviewing" the caseNo solution at all was providedSo we cannot accept the current response from HCC 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.Since the last BBC email, HCC Life Insurance Company informed us that they wanted the records from the optometrist of our sonI contacted the optometrist, secured the records and emailed HCC the complete records on the 9th of JanuaryIn the email I indicated that the single page being sent represented the entire records file the optometrist's office has for our sonI called HCC on the 15th of January to get the status and they informed me they are waiting on records from the optometrist's officeI informed them I had sent the complete records by emailThey said that they only received (1) pageHCC chose to ignore the communication in the email that the single page represented all the records that the optometrist has for our sonAdditionally they ignored the fact that I had sent the records to themThey did not call to verify that the single page represented the entire file for our sonI had to call to find out that they had labeled the file as incomplete/awaiting records and were again indefinitely sitting on our claimHCC informed me that they could not accept receiving the optometrist's records from meThey stated that the optometrist's office would need to form a letter indicating that the single page of records for my son represented all the records they have for himThen the optometrist's office would need to fax the letter with the single page of records directly to a new fax number that HCC gave meI contacted the optometrist once again and they graciously faxed both the letter and records for my son, to the number HCC gave us, on the 20th of JanuaryI spoke with HCC Life Insurance Company this morning (27th of January) and the claims department is "reviewing" our claimSo we are in the same situation that we were when we initially filed our complaint in December of HCC Life Insurance Company continues to delay their "review" and processing of our claimThe services provided to our son occurred nearly months ago and we are currently being threatened with being sent to collections by multiple entitiesAdditionally every statement/bill I receive from the medical providers I call them to give an updateMultiple have indicated to me that when they have called HCC Life Insurance Company and HCC has indicated to them that they cannot process the claim because they are waiting for me to fill out a "Claimant's Statement and Authorization Form"HCC provides this form to us to fill out for any particular incident or conditionIn fact I had filled out and sent in this form a long time prior to the providers calling HCCI spoke with [redacted] of HCC and he informed me that indeed they had received this form a long while back and that I could have any of the providers call him direct to verify thatThis was appreciated but doesn't change the fact that blatantly incorrect information has been given to the providers which has complicated my working with them to put off payment due dates while HCC "reviews" our claims.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 [Provide details of why you are not satisfied with this resolution.] Regards, [redacted] Still no answers
HCCMIS did pre-certify the medical procedure as the medical services were determined to be medically necessaryHowever, as is indicated in the precertication letter mailed to both the provider and insured, precertification does not guarantee coverage or payment of claims or benefitsSee the below language from the precertification letterPursuant to the policy, this precertification letter does not guarantee coverage or payment of claims or benefitsThis determination will be made only after complete claims information is receivedEligible Medical Expenses will be paid subject to all Policy terms, conditions and exclusions and the member's plan of benefits at the time services are renderedTo confirm benefits, please review the Certificate or call the toll-free number listed on your member ID cardBased on the above and the full review of the claims submitted, HCCMIS correctly denied the claims as they are not eligible under the policyConsequently, we are upholding our decision in this matterI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me knowSincerely, HCC Medical Insurance Services
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 have reviewed the policy definition of Pre-existing conditions, and I do not agree that the services received from Park N [redacted] t are included in this definition. The reason the MRI was ordered by the doctor was to rule out a possible tumor or other growth. I have never had such a condition in my life. I would like HCC to pay this claim ASAP to myself in the form of a check.Regards, [redacted]
Ms. [redacted] was covered under our Atlas America policy which is issued on a non-admitted basis to The Atlas / International Citizen Group Insurance Trust out of Hamilton, Bermuda. The insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCC MIS) is the administrator. We have... reviewed the claims and medical records concerning this matter. Ms. ***'s medical records indicate that Ms. [redacted] received treatment and experienced symptoms prior to purchasing our coverage. The policy contains a preexisting condition limitation for conditions existing prior to the effective date. Consequently, we are upholding our decision in this matter. I hope this information will allow the Bureau to conclude handling of this file. If I can be of any further assistance, please let me know. Respectfully, [redacted] (***) 447-0460 — Ext. [redacted] (770) 693-6485 — Direct [redacted] @hcclife.com Mailing Address: 225 TownPark Drive, Suite 350 Kennesaw, GA 30144
Mr [redacted] was covered under our Atlas International policy which is issued on a non-admitted basis to the Atlas / International Citizen Group Insurance Trust out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCC MIS) is the administrator I apologize that Mr [redacted] has had difficulty reaching our facilityWe have been working diligently to get the providers in Canada to respond to our requests for an itemization of certain of his claimsTo date, we have been unsuccessfulHowever, we are waiving those requirements and proceeding to adjudicate his claims on his behalf with these facilities I hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me know Respectfully, [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 This was NOT a pre-existing conditionThe irony is that neither I nor the providers know the cause of excessive belching and bloatingMy only pre-existing condition was stones in the gall-bladderThat condition is being confused with belching and bloatingI will go to any length to prove the truthIf it was a pre-existing condition then why did HCCMIS give me pre-approval for colonoscopy/upper endoscopy? Why didn't HCCMIS know while giving approval that they will not cover the cost of the procedure? WHAT IS THE POINT OF A PRE-APPROVAL if the costs are not covered at all? Please enlighten me.HCCMIS should refund all the premiums I paid if they are not going to pay for legit medical procedures/tests which were NOT about any pre-existing conditionBased on symptoms you can call any illness a pre-existing condition and hence keep making money by ripping people off! This issue is not settled and I 'll take every possible route to prove the truth Regards, [redacted] ***
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to me I will wait until for the business to perform this action and, if it does, will consider this complaint resolved I've resubmitted the forms online with an electronic signature weeks ago If the business does not resolve this matter promptly, I will submit another claim to the Revdex.com until this matter is taken care of Regards, [redacted]
We have reviewed the issues raised in Mr [redacted] 's complaint concerning his wife's policyWe had previously mailed our request for a claimant's statement to the address Mr [redacted] used when he purchased the coverageWhen the requested information was not received, her claim was closedIf Mr [redacted] wishes to appeal our decision, he should submit a claim form and the medical records from the providerWe will consider Ms [redacted] 's claim after our review of her medical records to determine if her treatment is a covered expense under the terms and conditions of her coverageIf we do not receive the requested information, the claim will be remain closedI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me knowRespectfully, Charles [redacted] Esq
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to meHowever, I would have preferred that HCCMIS acknowledge that the mistake was on their side, I have provided evidence to support thisI will wait for the business to perform the actions described in their reply and if the consequences of these actions are to my satisfaction, then I will consider this complaint resolved.Thank you for the prompt reply Regards, [redacted]
We have reviewed Mr [redacted] ’s situationMr [redacted] has failed to provide an itemized billing necessary to process his claimOnce this bill has been received, HCC Life Insurance Company will provide an Explanation of BenefitsI also note Mr [redacted] has not reached his policy deductibleI hope this information will allow the Bureau to condude handling of this fileIf I can be of any further assistance, please let me knowRespectfully, [redacted] , Esq
Ms [redacted] has insurance coverage through The Atlas / International Citizen Group Insurance Trust out of Hamilton, BermudaMs [redacted] incurred medical treatment for a condition that pre-existed her coverage or our companyMs [redacted] may appeal our decision in accordance with our policy by following the instructions in her certificateI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me know.RespectfullyCharles [redacted] , Esq770/693/6585-direct
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.We provided filled and signed claimant's statement and authorization form on November 25th of using few different methods: fax and through HCC customer account with Cisco Registered Envelope Service, however there was no reply on a fax anda reply with secure message that there was no attachmentsThen we sent it again, adding our email to CC of the message, there was no replyI'm attaching filled and signed claim form, proof of transmitted fax with hospital bill and claim form.BTW, they never sent us any letters this summer asking to fill any claims formThey dont have any proof of mailing itThe same way they treat any other customer who would write a complain, it's all over internet, bunch of complaints about this company with exactly same problem - They never mail any claim form to anyone to fill until enough time will pass so they can send letter explaining that case is closed due to lack of informationAfter they will offer to reopen the case, but will never accept any documents.They also never provide any names of the customer service representative who would talk to you.Anyway, claimant's form is attached as well as medical bill Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to me I will wait until for the business to perform this action and, if it does, will consider this complaint resolvedRegards, [redacted]
Mr [redacted] was covered under our Atlas policy which is issued on a non-admitted basis to [redacted] out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administratorHCCMIS has re-evaluated the 7/25/and 7/26/claims submissions for Mr***Upon review, we agree with Mr [redacted] that these claims were incorrectly denied and should be considered eligible for payment (subject to deductible and coinsurance)We will reprocess these claims immediately and have them sent to repricingWe apologize for the delay and inconvenience encountered by Mr***Mr [redacted] will receive new Explanation of Benefits shortlyI hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me knowSincerely, [redacted] HCC Medical Insurance Services%
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 Regards, [redacted] response 2/24/15HCC has a very well documented internet history using excuses not to pay on thier policy HCC has deemed my condition: pre-existing,,...when A]--the top expert in connectcut,Dr Wu,liver expert [published] Uconn john dempsey , still has no exact diagnosis for me ,the known is its a liver problem,I asked him about pre-existing,,,he stated his job is not for insurance companies,his job is to fix meB]I never in my entire life had an esophageal bleed,this is what I was hopitalized for , C] HCC has also deemed my hospital stay non emergency ,even though I almost died , D]HCC insisted follow up procedures be done at a hospital facility,instead of outpatient,the hospital was much more expensive,done only at HCC demands,and they still havent paid.significantly increasing costsE]HCC-pre approved EGD services for doctors offices,that they now are not payingF]Anthem,the company I replaced HCC with when I learned how bad HCC is,has paid every claim submitted,some are days literally away from cliams HCC hasnt paid,and some are claims HCC did not pay [i had double coverage 11/2014]G] to date HCC has not paid one dime,on all the claims they have recieved,using every excuse that can be thought of,non emergency-pre-existing [thier favorite] lack of records , lack of documents,lack of additional steps takenH] I personally provided my med records to HCC via registered mail,on burned CD"s,hence,lack of records,and no pre-existing esophageal bleed ever,is well documented,I was taken by ambulance to sharon hospital,in ICU for days,this was an emegency,regardless of HCC opinion of the matter...near death..to me , is an emergency Overall,HCC has a reputation of using excuses,,,coding issues , and any possible method not to pay , my only truly pre-existing condition is I was born,I have elevated all HCC claims to appeal level , I will progres to level , then level with the state of CT insurance commision , if resolve still cannot be met,litigation will definitely be opened against HCC by me,Lawyers,,,tend to resolve things,the list of complainants against CC is huge,there are entire websites about them and HCC techniques used not to pay claims...HCC needs to grasp,this IS NOT going awayAny simple internet search will find more cases than countable..of folks having problems with HCC paying claimsto resolve this, HCC needs to pay the claims sent to it regarding this matter,if this reaches litigation,damages will be sought [redacted] 2/24/
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 This company refuses to communicate on any human level I understand the terms of my insurance deductible, I am not disputing that My issue is that the policy advertises a dollar copay at urgent care facilities However when the customer actually goes to the urgent care facility the insurance is not accepted If they do not have a network of providers within my area they should not be allowed to sell me a policy One would think that if this was not a scam they would have provided me with information on where I should have gone instead of the ER A legitimate company would want to clear up this issue in hopes of future repeat business I am willing to settle for refund of my premium which is far less than my hospital bill I guess they need this $more than I do 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 Pre-Authorization from HCC Insurance letter dated March 12, approves for Certificate number [redacted] and Authorization number [redacted] for procedure Uterine Fibroid (diagnostic code 218.9) and Dysmenorrhea (625.3.) on May 16th During authorization process HCC was well aware this was for Uterine Fibroid and gave authorization for the procedure that came out as Uterine Fibroid (diagnostic code 218.9) and Dysmenorrhea (625.3.) which is exactly what they approved If this diagnosis was not covered under the policy then why/how could they authorize and not let anyone know (not even the patient) they were approving what they now claim is not covered on their policy Regards, [redacted]
Ms [redacted] was covered under out Atlas America policy which is issued on a non-admitted basis to the Atlas/International Citizen Group Insurance Trust out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administrator HCCMIS has received claims from Ms [redacted] , however, the Claimant's Statement and Authorization forms that have been received by HCCMIS have either been incomplete or not signed by Ms [redacted] Forms submitted by [redacted] cannot be accepted since they were not appropriately signed by Ms [redacted] The Claimant's Statement and Authorization form may be completed and signed • electronically via the ClientZone by visiting www.hccmis.comUntil the Claimant's Statement and Authorization form has been full completed and appropriately signed, HCCMIS is unable to reopen Ms [redacted] 's claims I hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me know Sincerely, [redacted] HCC Medical Insurance Services%3%
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 In the very short message from HCC insurance, it was only mentioned they "are reviewing" the caseNo solution at all was providedSo we cannot accept the current response from HCC 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.Since the last BBC email, HCC Life Insurance Company informed us that they wanted the records from the optometrist of our sonI contacted the optometrist, secured the records and emailed HCC the complete records on the 9th of JanuaryIn the email I indicated that the single page being sent represented the entire records file the optometrist's office has for our sonI called HCC on the 15th of January to get the status and they informed me they are waiting on records from the optometrist's officeI informed them I had sent the complete records by emailThey said that they only received (1) pageHCC chose to ignore the communication in the email that the single page represented all the records that the optometrist has for our sonAdditionally they ignored the fact that I had sent the records to themThey did not call to verify that the single page represented the entire file for our sonI had to call to find out that they had labeled the file as incomplete/awaiting records and were again indefinitely sitting on our claimHCC informed me that they could not accept receiving the optometrist's records from meThey stated that the optometrist's office would need to form a letter indicating that the single page of records for my son represented all the records they have for himThen the optometrist's office would need to fax the letter with the single page of records directly to a new fax number that HCC gave meI contacted the optometrist once again and they graciously faxed both the letter and records for my son, to the number HCC gave us, on the 20th of JanuaryI spoke with HCC Life Insurance Company this morning (27th of January) and the claims department is "reviewing" our claimSo we are in the same situation that we were when we initially filed our complaint in December of HCC Life Insurance Company continues to delay their "review" and processing of our claimThe services provided to our son occurred nearly months ago and we are currently being threatened with being sent to collections by multiple entitiesAdditionally every statement/bill I receive from the medical providers I call them to give an updateMultiple have indicated to me that when they have called HCC Life Insurance Company and HCC has indicated to them that they cannot process the claim because they are waiting for me to fill out a "Claimant's Statement and Authorization Form"HCC provides this form to us to fill out for any particular incident or conditionIn fact I had filled out and sent in this form a long time prior to the providers calling HCCI spoke with [redacted] of HCC and he informed me that indeed they had received this form a long while back and that I could have any of the providers call him direct to verify thatThis was appreciated but doesn't change the fact that blatantly incorrect information has been given to the providers which has complicated my working with them to put off payment due dates while HCC "reviews" our claims.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 [Provide details of why you are not satisfied with this resolution.] Regards, [redacted] Still no answers
HCCMIS did pre-certify the medical procedure as the medical services were determined to be medically necessaryHowever, as is indicated in the precertication letter mailed to both the provider and insured, precertification does not guarantee coverage or payment of claims or benefitsSee the below language from the precertification letterPursuant to the policy, this precertification letter does not guarantee coverage or payment of claims or benefitsThis determination will be made only after complete claims information is receivedEligible Medical Expenses will be paid subject to all Policy terms, conditions and exclusions and the member's plan of benefits at the time services are renderedTo confirm benefits, please review the Certificate or call the toll-free number listed on your member ID cardBased on the above and the full review of the claims submitted, HCCMIS correctly denied the claims as they are not eligible under the policyConsequently, we are upholding our decision in this matterI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me knowSincerely, HCC Medical Insurance Services
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 have reviewed the policy definition of Pre-existing conditions, and I do not agree that the services received from Park N [redacted] t are included in this definition. The reason the MRI was ordered by the doctor was to rule out a possible tumor or other growth. I have never had such a condition in my life. I would like HCC to pay this claim ASAP to myself in the form of a check.Regards, [redacted]
Ms. [redacted] was covered under our Atlas America policy which is issued on a non-admitted basis to The Atlas / International Citizen Group Insurance Trust out of Hamilton, Bermuda. The insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCC MIS) is the administrator. We have... reviewed the claims and medical records concerning this matter. Ms. ***'s medical records indicate that Ms. [redacted] received treatment and experienced symptoms prior to purchasing our coverage. The policy contains a preexisting condition limitation for conditions existing prior to the effective date. Consequently, we are upholding our decision in this matter. I hope this information will allow the Bureau to conclude handling of this file. If I can be of any further assistance, please let me know. Respectfully, [redacted] (***) 447-0460 — Ext. [redacted] (770) 693-6485 — Direct [redacted] @hcclife.com Mailing Address: 225 TownPark Drive, Suite 350 Kennesaw, GA 30144
Mr [redacted] was covered under our Atlas International policy which is issued on a non-admitted basis to the Atlas / International Citizen Group Insurance Trust out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCC MIS) is the administrator I apologize that Mr [redacted] has had difficulty reaching our facilityWe have been working diligently to get the providers in Canada to respond to our requests for an itemization of certain of his claimsTo date, we have been unsuccessfulHowever, we are waiving those requirements and proceeding to adjudicate his claims on his behalf with these facilities I hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me know Respectfully, [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 This was NOT a pre-existing conditionThe irony is that neither I nor the providers know the cause of excessive belching and bloatingMy only pre-existing condition was stones in the gall-bladderThat condition is being confused with belching and bloatingI will go to any length to prove the truthIf it was a pre-existing condition then why did HCCMIS give me pre-approval for colonoscopy/upper endoscopy? Why didn't HCCMIS know while giving approval that they will not cover the cost of the procedure? WHAT IS THE POINT OF A PRE-APPROVAL if the costs are not covered at all? Please enlighten me.HCCMIS should refund all the premiums I paid if they are not going to pay for legit medical procedures/tests which were NOT about any pre-existing conditionBased on symptoms you can call any illness a pre-existing condition and hence keep making money by ripping people off! This issue is not settled and I 'll take every possible route to prove the truth Regards, [redacted] ***
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to me I will wait until for the business to perform this action and, if it does, will consider this complaint resolved I've resubmitted the forms online with an electronic signature weeks ago If the business does not resolve this matter promptly, I will submit another claim to the Revdex.com until this matter is taken care of Regards, [redacted]
We have reviewed the issues raised in Mr [redacted] 's complaint concerning his wife's policyWe had previously mailed our request for a claimant's statement to the address Mr [redacted] used when he purchased the coverageWhen the requested information was not received, her claim was closedIf Mr [redacted] wishes to appeal our decision, he should submit a claim form and the medical records from the providerWe will consider Ms [redacted] 's claim after our review of her medical records to determine if her treatment is a covered expense under the terms and conditions of her coverageIf we do not receive the requested information, the claim will be remain closedI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me knowRespectfully, Charles [redacted] Esq
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to meHowever, I would have preferred that HCCMIS acknowledge that the mistake was on their side, I have provided evidence to support thisI will wait for the business to perform the actions described in their reply and if the consequences of these actions are to my satisfaction, then I will consider this complaint resolved.Thank you for the prompt reply Regards, [redacted]
We have reviewed Mr [redacted] ’s situationMr [redacted] has failed to provide an itemized billing necessary to process his claimOnce this bill has been received, HCC Life Insurance Company will provide an Explanation of BenefitsI also note Mr [redacted] has not reached his policy deductibleI hope this information will allow the Bureau to condude handling of this fileIf I can be of any further assistance, please let me knowRespectfully, [redacted] , Esq
Ms [redacted] has insurance coverage through The Atlas / International Citizen Group Insurance Trust out of Hamilton, BermudaMs [redacted] incurred medical treatment for a condition that pre-existed her coverage or our companyMs [redacted] may appeal our decision in accordance with our policy by following the instructions in her certificateI hope this information will allow the Bureau to conclude handling of this fileIf I can be of any further assistance, please let me know.RespectfullyCharles [redacted] , Esq770/693/6585-direct
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.We provided filled and signed claimant's statement and authorization form on November 25th of using few different methods: fax and through HCC customer account with Cisco Registered Envelope Service, however there was no reply on a fax anda reply with secure message that there was no attachmentsThen we sent it again, adding our email to CC of the message, there was no replyI'm attaching filled and signed claim form, proof of transmitted fax with hospital bill and claim form.BTW, they never sent us any letters this summer asking to fill any claims formThey dont have any proof of mailing itThe same way they treat any other customer who would write a complain, it's all over internet, bunch of complaints about this company with exactly same problem - They never mail any claim form to anyone to fill until enough time will pass so they can send letter explaining that case is closed due to lack of informationAfter they will offer to reopen the case, but will never accept any documents.They also never provide any names of the customer service representative who would talk to you.Anyway, claimant's form is attached as well as medical bill Regards, [redacted]
Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this resolution would be satisfactory to me I will wait until for the business to perform this action and, if it does, will consider this complaint resolvedRegards, [redacted]
Mr [redacted] was covered under our Atlas policy which is issued on a non-admitted basis to [redacted] out of Hamilton, BermudaThe insurance is underwritten by Lloyds, London and HCC Medical Insurance Services (HCCMIS) is the administratorHCCMIS has re-evaluated the 7/25/and 7/26/claims submissions for Mr***Upon review, we agree with Mr [redacted] that these claims were incorrectly denied and should be considered eligible for payment (subject to deductible and coinsurance)We will reprocess these claims immediately and have them sent to repricingWe apologize for the delay and inconvenience encountered by Mr***Mr [redacted] will receive new Explanation of Benefits shortlyI hope this information will allow the Bureau to conclude the handling of this fileIf I can be of any further assistance, please let me knowSincerely, [redacted] HCC Medical Insurance Services%