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Insurance
Type: long term disability
Insurer: StandardAfter
carrying me for 11 years for CFS, Standard just dropped me. as result, I am exhausting
myself running around to more doctors and taking more tests -- all costs born
by my health insurance company -- in order to reestablish disability for this
lifelong illness that waxes and wanes. I'm one of the lucky ones as I have money
to appeal and to sue.
Insurance
Type: medical/dental
Insurer: Anthem Blue Cross and Blue Shield
My
family has never needed to use insurance for emergency purposes until may of last
year. My son was hit in the mouth by a baseball bat (complete accident) and knocked
out several teeth and traumatized others. Anthem denied every single claim I sent
them until I appealed and the claim went to the Office of Insurance of KY (an
independent law firm...free service to me)
When
this office reviewed the claims, Anthem had to pay. So up until now, they have
paid for my son's implants (they weren't going to pay for temporary ones so we
used permanent ones even though he was only 16) So now they paid for the implants
but they just denied payment for the veneers to go on the implants! Explain that?
Of course I will appeal and they will deny and then I will send it to the office
of insurance and they should overturn this decision. We will not be with Anthem
as of Oct 1.
Insurance
Type: long term care
Insurer: traveler's/citi
My
mom, is 85 years old. Although she lives on a modest fixed income, years ago she
made a commitment to purchase long term health insurance to provide for nursing
home care should the need arise. She scrimped over the years but has faithfully
paid her $3400 policy and never had a claim.
Now
she got a letter stating that premiums are going up and that to maintain her policy
she needs to pay $4700 a year. Her other options are to drop the policy or to
accept sharply reduced benefits. My mom was truly shocked to find herself in this
predicament. Apparently somewhere in the small print of her policy, such huge
price hikes are allowed? Where are the legislators who are supposed to be protecting
senior citizens who tried to do only the right thing. This is truly a sham!
Insurance
Type: Healthcare
Insurer: Blue Cross/Blue Shield Health Options
In
1997 I called my healthcare insurance provider, Blue Cross/Blue Shield for pre-approval
on some medical testing to determine whether I had a sleep disorder. I was assured
my coverage would pay for the testing. The testing was conducted over a series
of four or five sessions and the bill came to around $10,000. When the claim was
filed, Health Options denied the claim citing PRE-EXISTING CONDITION.
By
their definition (which was detailed in the booklet they provided when I took
out the policy through my employer) I didn't see how they could come to that conclusion.
I had never been diagnosed with the condition, I had never been examined for the
condition, I had never been treated for the condition, and had no clue that I
even had the condition.
InsuranceType:
group LTD disability
Insurer: Prudential Insurance Co of America
I
have Fibromyalgia and am recovering from a craniotomy for Pituitary
Macroadenoma.
I have severe symptoms from my Fibromyalgia and residual hormone deficiencies
due to the brain tumor. Injury to my pituitary gland cause sight difficulties
and inability to read or do computer work for more than a short time before I
get bad headaches and widespread body pain from sitting at the computer. After
2 years of payment (which I obtained after 1 year of fighting Prudential) which
I received when it was discovered that I had a brain tumor that would have to
be removed via cutting through my skull. I lost some of my sight from the tumor
and damage after the surgery caused me to continue to have difficulties. I have
thyroid deficits and growth hormone deficits.
The
former is now controlled but the latter has not yet begun to
come under control.
I was awarded social security disability benefits with the minimal assistance
of a non-attorney that Prudential hired to assist me with my claim. When, I received
a favorable judgment from the Administrative Law Judge, without the need for a
trial, Prudential cut off my supplemental payments which should have been reduced
but not cut off completely. Prudential also started to demand repayment of the
lump sum from SSD even though they were no longer paying my rightful benefits.
Isn't it funny that a large corporation hired someone to prove to the government
that I am disabled then after award turns around and declares me not disabled
for their policy. They even refuse to consider the Judge's opinions of the medical
evidence that I provided without any help from the so-called legal assistance
that they hired. I have sent Prudential all of the records provided to SSD. It
is amazing that a Judge would declare sufficient "objective evidence"
and Prudential claims there is none!!!!!
I've
made three written requests for my claims file and any other pertinent information
used in making their decision (January, April, and June)all 3 requests were ignored.
Prudential claims nonreciept of the appeal I sent in January, even though I have
confirmation of delivery to
Prudential's P.O. Box.
There
are many other tricks and violations they have
put me thru.
