I work for a company in Baltimore, MD that uses Performax. I know of two separate incidents where Performax has tried to pass the buck. First a co-worker cut his finger on a saw about four months ago and had to get some stitches. Performax rejected the claim ($450) and he is still fighting with them.
The second incident was a dog bite. Another co-worker got bit on his lip by a dog (the dog belonged to a friend and it was an accident). He went to the emergency room then to a surgeon to get his lip reconstructed (it was a bad bite).
Again Performax rejected the claim and sent out some sort of legal letter asking if he was going to sue the dog's owner? He called Performax to say he wanted to know if they were going to cover the claim before he decided if he needed to take any kind of legal action. Performax came back saying they needed to know if he was going to sue before they decided if they were going to cover it. This incident recently occurred and the fight has just begun.
I always thought the whole point of PAYING for health insurance was to have the reassurance that if anything happened to you, you would be covered.
Note that neither of these accidents were the result of anyone negligence and were totally accidental. Performax seems to just reject all claims and then see what happens.
I have spoken with insurance agents from other companies who say this is absurd, and that Performax is just trying to pass the buck.
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