We were told by the United American Insurance agent, that this company is an A1 rated company, and that is the best rating any insurance company can attain. She didn't tell us that the rating is based on the Medicare supplementation side of the company. She presented the FlexGuard plan as the best available insurance plan to meet our needs.
We signed up to get my wife covered. This was in July. There is a rider on the policy noting her asthmatic condition, nothing else.
Our policy was mailed to us, and the agent CALLED to go over the policy. At the time, we noticed wording like LIMITED, FIXED AMOUNT, regardless of your expenses, IF you meet other policy conditions.
Policy is titled, Limited Benefit Hospital and Surgical Expense Policy. It gives a 30day right to examine option, yet has a time limit to begin using the policy.
The agent never sat with us to face-to-face cover each section of the policy. When my wife injured her wrist in a bike accident that was later determined to have progressed to Carpal Tunnel Syndrome, we assumed the policy would cover 80% of all the expenses outside the $500 deductible. We discovered very quickly they were not about to cover anything near what the agent claimed they would.
They first denied us because of the asthma rider... How can asthma cause Carpal Tunnel Syndrome? They are only paying the Surgeon's fees at a doctor's visit rate ($25), instead of 80% of what a surgeon would charge for consultation and follow-up visits.
They are not paying 80% of hospital charges, but some made-up limit of $7500.
Basically they will fight any policy holder in this FlexGuard plan on any claim hoping you will go away.
I have reported them to the Colorado State Insurance Commissioner. Their response has been to drag out the process claiming doctors and hospitals are not providing them with records. They are still trying to pawn off the cause of the CTS to asthma.
Don't deal with these people, unless you like to throw money into a dark hole.
0 comments