Complaint / Review
Essential Health
Bogus Denial on Benefits

Re: Appeal on Bogus denial

I have been a good customer and was happy with the service I was receiving until this claim, an emergency room claim for $300 from a verified Emergency Room hospital serving the Sonoma County residents.

For 7 months I was given reason after reason with requests for more documentation on why it wasn’t fulfilled. I have had the hospital fax you direct for months with no response, then I sent you my entire medical record in September from the hospital-showing repeatedly the service rendered from an emergency room doctor at 1130 pm on February 20th.

I am both very angry and disappointed that a big company, part of AIG would try anything to get out of paying a justified and verifiable valid claim under your underwriting guidelines-IF, you had actually done a proper investigation, instead of assuming this is a satellite emergency care center with no doctor 24 hours a day-why I call your denial Bogus and this HUGE waste of my time when I could be spending it making a living (self employed) is not only damaging to my income but a true example of scams across America.

Essential Health Claims
c/o Program Administrators for
National Union Fire Insurance Co.
William B Davis