Quite honestly I don't know where the blame resides for my complaint, but since the ultimate purchase was for health insurance (which I found out later does not qualify technically as health insurance) from UCAA, I have listed them as the business I am complaining about. I actually believe that this complaint is more applicable to shady agents who respond to our requests for insurance information over the internet through sites such as einsurance.com. Here's my story for whatever it is worth to anyone out there.
I was searching for individual/family health insurance options on einsurance.com with the objective of trying to lower my health insurance premiums and retain good health coverage. I found several health insurance plans that I was interested in and printed out my comparison to be ready to discuss the plans when the agent called. I received several automated calls to set up the time to speak with an agent. When the agent called at the appointed time, he immediately re-directed me from the health insurance plans that I expressed interest in, stating something like (and I'm paraphrasing), well, youll never get the premiums that are advertised. Those are gimmicks. I suppose this should have clued me in. He then asked me what my goals were, how I tended to use my insurance, etc. Then he said he would check on what other options he had available. After a few minutes of 'his checking' while I'm on hold, he returned and said he had found something for me but there were only two openings left as this was part of an association I had to join and they only allowed so many new members per year.
The agent then started to sell me on the UCAA Health Option One Elite Plus plan. He did say this was a Limited Medical Indemnity plan, but since I never looked into Limited Medical Indemnity plans, I was totally unfamiliar with them and I guess that made me the prime sucker, i.E., I was relying on his honesty to describe the plan. The agent told me that this was a first pay system, or something like that, in which all my costs are covered upfront, up to limits established by the policy. He went through the number of doctor office visits per year (14 total or 7 per person), number of diagnostic/x-ray/laboratory visits per year, hospital days (31 days), etc and repeatedly confirmed for me that all of these would be covered at 100%. After using the allowed maximum visits/days at 100%, he explained that my obligation or co-pay would be 30% of the costs with the plan paying the remaining 70%.
I tried to take notes, but he rattled through all of this too fast for me to get it down in detail, but I did repeatedly ask him to confirm that I understood what he said. I specifically asked about a colonoscopy because my wife had one a few years ago and we were surprised by all the charges from multiple sources for this procedure. So, I specificaally asked, "if I have a colonoscopy, it will be covered at 100%, right? Because my wifes colonoscopy costs well above $2000 after everybody and their brother had sent us bills and when she asked the doctor's office prior to the procedure she was told $500." He confirmed that I was correct in my understanding, it would be covered 100%.
He then explained some other benefits, like a small life insurance policy, that came with membership in the UCAA and asked for my credit card information, which I gave him to cover the first month's premium of $529 and the nonrefundable application fee of $99.95. I know I shouldn't have, but I trusted him. He then transferred me to the verification agent who went through a series of generic Q&A (we never discussed the details of the policy) and the deal was completed.
Well, imagine my surprise when my brochure shows up in the mail the following week and I discover doctors visits only cover $105 for the allowed number of visits and nothing after that, diagnostic/x-ray/lab only covers $100 per visit and nothing after that, hospital stays are limited to $1000 per day and nothing after that, etc, etc. So, I was not covered at 100% for the first services as was explained to me and there was no 30% co-pay after the initial coverage limits were met, I would be responsible for 100%.
In my opinion, this guy scammed me and Im sure hes scamming others. Unfortunately, when I was taking notes during his hasty narration of the benefits, I was writing on scratch paper and threw it away, so I don't have his name or number or my notes.
I called UCAA and expressed my anger and requested to have my policy cancelled and my first month's premium refunded. They agreed to do so since I was well within my 30 day grace period. And, after sending a complaint e-mail to UCAA customer service, I received a followup call and they have agreed to refund my $99.95 application fee. They say they are serious about looking into this agent's false claims and will have a discussion with the concerned agents office to resolve the issue with them.
I am posting this complaint hoping that someone will read it before being suckered into buying a policy like I was. My advice, which I am going to follow consistently from now on, is never purchase anything without seeing the details in writing first and having some time to digest the benefits, the Terms and Conditions, and the exceptions and exclusions. I knew better than this, but I did it anyhow. Never again!
So, based on this experience I want to caution anyone who is attempting to buy health insurance via an internet contact. Evidently, even reputable companies, like United Consumer Awareness Association appears to be after all of this fiasco, are being sold by agents with questionable integrity. Buyer beware!!!
This is the most outraged I have ever been with a purchase I have made.
It has been the most dishonest, and as I said, I think it is criminal.
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