We have had 2 claim denials from HMS. First, we had a leak in the upstairs shower. HMS could not find a repairman (no service men in our town would work with them - I called all to ask). They had me find a plumber 25 miles away to come look at the leak. I asked them if they would pay their trip charge ($75). They said yes. Plumber came and needed to cut into sheetrock. HMS said they would fix the sheetrock. Leak turned out to be due to bad caulk and HMS denied paying trip charge, sheetrock repair and plumber charge. They agreed to pay trip charge and sheetrock repair only hours and minutes before.
Our second denial is related to our air conditioning. It died in August (100 degree weather). I had a toddler and an infant. I mistakenly did not call HMS to have them handle it. I simply forgot that we even had the policy. When renewal time arrived, I spoke with a customer service representative and asked her if we would get any reimbursement if I could prove the unit died and it was a valid repair. She said we would get some reimbursement and to send the invoices in. We renewed. I made a special trip to the repairman, who detailed our problem.
Our claim was determined to be valid, but the contract states that "We have sole authority to select authorized contractors. All repair and/or replacement work covered by this Agreement must be performed by an authorized contractor and approved by us in advance. We are not responsible for expenses you incur without our express consent. You will not be reimbursed for any costs associated with unauthorized repairs or work performed by unauthorized contractors."
We did not even get a small reimbursement. We did not follow instructions, but they will not work with us at all.
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