Complaint / review text:
Horizon Blue Cross Blue Shield of New Jersey wilfully ignored my claims and committed an act of bad faith insurance resulting in me having to drop the policy as I had to pay my provider out of pocket.
This company is a rip-off.
In May 2008 I was treated for possible Lyme disease after receiving a tick bite. I had a self-insured plan and I knew about the pre-existing condition limitation.
However, a tick bite and following symptoms should not be considered a pre-existing condition if it happened after the policy began.
My provider filed the relevant doucmentation with Horizon Blue Cross Blue Shield of New Jesey several times and each time Horizon refused to pay saying they had to review the claim for pre-existing condition.
Months passed. I called and called and was told in June that Horizon had received the information from the provider and a decision would be made in 60 BUSINESS DAYS.
September arrives and NO DECISION HAS BEEN MADE. I phone and send letters which are ignored.
I call again in October and I am told by one of their reps that my case will be expedited - WHAT DOES THAT MEAN? It is February 2009 and still I have heard nothing.
I sent a letter in November telling them I would take action if they failed to address my claim. Meanwhile, my provider told me I would be responsible for the bill as Horizon refused to pay the claim.
In January I finally receive a letter from Horizon telling me what I already know: my claim had been denied for pre-existing condition review and they needed INFORMATION from the PROVIDER which they already had since June 2008.
I appealed this ridiculous decision and will take legal action against them shortly.
They are the WORST company to do business with - they will delay, deny and ignore your correspondence and when you phone them they will tell you "you're not the only one who has to wait"
Do NOT do business with this Company. They take your premiums from you month by month and when you need surgery or treatment they will find ways to avoid paying.
Horizon blue cross blue shield of new jersey is a rip-off.