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Tokio Marine HCC Medical Insurance Services Group / HCCMIS.com

Tokio Marine HCC Medical Insurance Services Group / HCCMIS.com review: Claim non-fullfilment 50

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3:46 pm EST
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Bought Atlas Insurance product from this company in march for my mother. Took her to gastroentrologist for diagnosis and treatment of bloody diahorrea in end of march. She undergone endoscopy and colonoscopy for diagonsis. Doctor's office and hospital facilities filed claim directly to HCCMIS. Since then claims are pending with the company on pretext that all documents are not received from doctor's office. First hccmis said documents not recieved from primary care physician. Once I got that resolved by talking to primary care physician and still claims are not settled for three months, I called hccmis again. This time I am told documents are pending from gastroentrology office. In July, gastroentrology office confirm sending the documents. In August, I checked again with hccmis and got the same information that documents are pending from gastroentrologist office. Again talked to gastroentrologist office for resending the documents and they confirm resending those. In october, again same excuse from hccmis that documents missing from gastroentrologist office. This time I conferenced in gastroentrologist office and hccmis and while of phone the doctoros office resend the documents and hccmis confirmed that documents are recieved and asked for 30 days for decision. There after called hccmis multiple times in november and december and they keep on saying that documents are recieved and they are awaiting decision from their claims office. Then suddenly in January this year, hccmis sent a letter that all claims are denied because they haven't received documents from gastroentrologist. Also mentioned that no further action is going to be taken as the deadline for claim has expired. Overall even after recieving documents and confirming that documents are received they denied the claim. Hccmis takes huge time in between conversations to notify to us that something is missing and then suddenly made decision that time for submitting documents have expired eventhough they confirmed that documents have been received.

Keep away from this company. It is SCAM.

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The complaint has been investigated and resolved to the customer’s satisfaction.

50 comments
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Muhammad Yasin
Muhammad Yasin
Indianapolis, US
Send a message
Jan 18, 2011 7:45 pm EST

Hello Piyush,

My name is Muhammad Yasin, I am the Manager of Claims & Client Relations for HCCMIS. I am sorry to hear that you are having a hard time with the product you purchased from us and would like to offer my assistance. We cover over thousands of individuals traveling abroad every year and never intend to deprive a member of benefits due to them under the policy they purchased. I have sent a private email to you with my direct contact information.

I am looking forward to hearing from you and will assist in any way I can.

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rdhivya
Renton, US
Send a message
Feb 21, 2011 6:31 pm EST
Verified customer This complaint was posted by a verified customer. Learn more

I am exactly in the same boat as Piyush where I bought the same insurance for my dad. My dad fell ill with fever and stomach ache and had to see the doctor. The doctor reccommended a scan and the bills were sent to HCCMS for claim and they came back to us asking for additional information and we provided the same. since then, i hear no information other than the claim is in process. i have called repeatedly to receive no information other than that the claims are in process and all of a sudden, they are telling me today that mostly the insurance would be denied as the time as expired. i was extremely shocked and i am planning to go to my attorney on this. I do not want any of my fellow folks to be cheated & scammed by this company ever. i also plan on writing about this in detail in my blog and bringing awareness on what this company does. KEEP AWAY FROM THIS COMPANY!

Muhammad Yasin
Muhammad Yasin
Indianapolis, US
Send a message
Feb 22, 2011 10:15 pm EST

Hello rdhivya,

I am disappointed to hear that you are having trouble as well. I have sent you a private message with my direct contact information. Please contact me at your earliest convenience and I will be happy to assist you.

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cincoh
US
Send a message
Mar 28, 2011 11:57 pm EDT

rdhivya & Piyush:

Thank you for posting your experience!

I've purchased short term insurance for my parents from this company in the past, but never had to use it. My parents are visiting this year, and I was going to get insurance from this people again. But luckily I found your posts.

I would never give my hard earned money to some cheater.

Thanks again.

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Vikas Malyala
Santa Clara, US
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Apr 05, 2011 10:40 pm EDT

I am having exactly same experience as the above mentioned people. HCC MIS looks like a SCAM. I should have checked it before taking insurance from these people. I took the insurance from these people everytime my parents visit US but they never visited a doctor. This is the first time my father had a problem in his knee while going for a walk. We contacted HCC and go the pre-authorization, etc and followed their requirements and reached the doctors on the network. The service providers did the same - go the pre-authorization for treatment. All that they did is an x-ray, MRI, etc and adviced a minor surgery. Due to the immigration rules, my father had to return to India. Because of his situation, we had to accompany him. When I came back from India, I found a letter from HCC and many invoices from the service providers asking for payment. I called HCC and they asked me to mail a signed document from my father and I had to get that from him. Once I mailed it to HCC, they told that they did not receive it so I faxed the document. After couple of attempts, they told that they received it and it will will take 45 days to release the payments. Until now, it was not paid and today the CSR told that my claim might be denied due of their many policies written in some document and I am responsible for payments. Today also I was in call for hours together and each CSR gives different reasons. If it was policy, how come all the CSR don't know and only one person knows. It is definitely a SCAM. I would be better off not taking any insurance and pay to the service providers directly. What a waste of time and money. Just now, i sent a letter to one of their supervisors 'Cinnamon' asking for help. I am going to spread my experience to all my friends as I am the one who recommended this to many of them. If Muhammad Yasin can help me too, I will greatly appreciate that.

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SanjayG
ewewr, US
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Apr 22, 2011 11:29 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

This company is a 100% SCAM with no doubt, finally after battling for year and half, i gave my file to a lawyer and let see how things go from there. I honestly request everyone for not recommending this insurance to your know or unknown friends.

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Ashish kaul
Chicago, US
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Apr 30, 2011 4:34 pm EDT

I was just about to buy this insurance for my mother
After reading these posts, I never will from this company.

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VijayN
IN
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May 20, 2011 3:03 am EDT

Glad to find these posts while trying to make a decision on buying from this company.

Piyush, Divya,

Was Yasin able to assist?

Muhammad Yasin
Muhammad Yasin
Indianapolis, US
Send a message
May 25, 2011 4:11 pm EDT

Hello everyone. Unfortunately, the person who made this post did not respond to me so I was unable to assist. However, I would be happy to assist any of you with questions or concerns you may have. I will sending each of you my personal email address via private message on this site.

We cover over 140, 000 travelers a year with our product and always intend to provide a product and quality of service that meets or exceeds the standards of our clients. I look forward to hearing from you and hope I can help all of you with your concerns.

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Enkaygee
Philadelphia, US
Send a message
Jun 03, 2011 7:47 pm EDT

My dad and mom visited USA last year. We bought the medical insurance from HCCMIS. My dad was to be hospitalized for less than a week for a massive hemetemesis and being pulseless and hypotensive. I had to use an ambulance. As soon as I got the time I phoned HCCMIS and kept the agent/s informed about ER treatment and afterwards admission. After nearly a year I hear that none of the services are being paid - reason stated being 16 (Amounts shown as excluded amount represent charges which are not covered under your insurance). Some of the claims made a comment - NO BENEFIT AVAILABLE UNDER THIS PLAN WHEN ELIGIBLE FOR MEDICAID. I shall leave you all who read this post to decide- what to do for your future insurances? I will definitely search for a different insurance carrier for their next visit.

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Srikanth - P
US
Send a message
Jun 15, 2011 10:26 pm EDT

Thank god I saw this. will never buy from this SCAM artists..

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CHEKKA RAMA GOPAL
IN
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Aug 19, 2011 10:22 pm EDT
Verified customer This complaint was posted by a verified customer. Learn more

I am also one of the aggrieved. I submitted 2 bills one for consultation $100 and another medicines for $30. The worst insurance company HCCMIS made all attempts not to pay. First, they said that they did not receive medical records from physician. When doctor sent again, they disallowed both biils. They always say and write to send itemized bills. Receipt of doctor for consultation charges is not adequate to them. Bills of CVS pharmacy are not sufficient. Every time, call is made they say, "Send itemized details", like a parrot. They want to avoid to make a small payment of $30 even as the first $100 I paid goes towards deductible, which they do not want to treat.
This is the worst insurance company I have come across, so cheap company to avoid even $30.
I feel I could have seen the numerous worst reviews of this company. On phone, they keep us hanging for hours to make us disconnect and drop the claim. They do not allow the aggrieved to speak to their higher authority even. Worst ever had this type of experience.
As a professor, I tell my students what worst experience I had. Students are the best agents to propagate this company to sink.
This is a first class scam company in USA.
My ID # IM [protected].
iNSURED: CHEKKA RAMA GOPAL

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M Pathak
US
Send a message
Sep 20, 2011 8:03 pm EDT

I strongly agree with Peeyush and Divya and warn everyone who is planning to buy insurance from HCC. We bought insurance from them when our In-laws visited us this year. In May 2011, my father in law got fainted one day and when we went to hospital they said he has had stroke. He was air lifted to the nearest big hospital and was admitted for 5-7 days. We started contacting HCC since day 1 and informed them about the entire situation. Once he came back home, we started getting various bills which went on and on for months. We made numerous calls to HCC checking about the status and every time we were told that additional information requested from service provider. On day we got a call from Mercy St John’s that they are referring our case to credit agencies due to late payments. We told them that HCC has asked additional information from you and hospital said we have already given everything months back and now we had to report this to credit agencies. Somehow we connected both of them together and resolved this mess. Now last week HCC has sent us a bill of $47, 000 denying everything saying Pre-existing condition as a reason. I wonder how can a stroke be a pre-existing condition? This firm is a complete fraud and now we are discussing with attorneys to help us out.
Beware never but anything from them. They are complete fraud.

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SWolfe1
Columbus, US
Send a message
Sep 27, 2011 3:03 pm EDT

I work for a doctors office and there is a patient that has this insurance and we are getting the same run around! BUYERS BEWARE! We have sent records multiple times and finally the HCC Medical denied the claims as timely...I will be contacting the Department of Insurnace and reporting this company.

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Munish11
US
Send a message
Oct 31, 2011 6:46 pm EDT

I am also having similar kind of experience what have been stated by others. I purchased insurance for my father who visited me from India. My father got his shoulder sprained due to a minor injury. After doing X-ray/ City Scan, physician determined the problem due to 'Shoulder Impingement' and my dad took physical therapy sessions for the same. HCC Medical kept on dragging the claims for 5 months for one reason or another. I sent them my father's authorization for processing the claims through all possible means in current world - Email/ Mail Post/ Fax. Thereafter, they kept saying that they are waiting for medical records from physician. However, I found that physician has sent everything and they kept telling physician that they are waiting for my father's authorization. And finally after 5-6 months of back and froth, they denied all claims citing as 'Pre Existing condition'. I wonder how could an injury be a pre-existing. To put it in simple words, they are in business of fleecing people in a very systematic manner. I consider myself unfortunate that I didn't check their reviews before buying the insurance. One more thing which I noticed is regarding their Target Customers. Most of the cases where such cases happen are those when person is from a different country and would definitely go back in sometime and there would be very less complaints in such cases. I would request the sufferers to spread the word around (by all possible mediums) so that no one else get cheated and I myself will surely do it.
My father's id: A9471858

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arnab1978
Staten Island, US
Send a message
Nov 01, 2011 4:28 pm EDT

I completely agree these guys are scamsters, they took 1000 dollars in premium and refuse to pay anything .. they should be sued in federal court for insurnace malpractice and fraud

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arnab1978
Staten Island, US
Send a message
Nov 01, 2011 4:30 pm EDT

These guys are scamsters, thugs and cheats, they took a premium of 1000 dollars and refuse to pay anything, they word their policies in a slick way that they exonerate themselves from any payment, they should be sued in federal court for malpractice and should be shut down for good

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arnab1978
Staten Island, US
Send a message
Nov 01, 2011 4:35 pm EDT

Muhammad Yasin, the client services manager, YOU GUYS ARE THUGS AND SCAMSTERS, AND YOUR GREEDY COMPANY SHOULD BE SHUT DOWN IMMEDIATELY AND ALL OF YOU SHOULD BE SENT TO JAIL FOR DEFRAUDING PEOPLE, BY TAKING HIGH PREMIUMS FROM UN-SUSPECTING PEOPLE AND THEN REFUSING TO PAY FOR EVEN AN X-RAY, HOW CHEAP CAN YOU GUYS CAN BE ? I SINCERELY HOPE THAT FEDS SHUT YOUR SCAM SHOP DOWN

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arnab1978
Staten Island, US
Send a message
Nov 01, 2011 4:37 pm EDT

IF ANYONE CONSIDERS A CLASS ACTION AGAINST THESE THUGS I AM READY .. IT IS HIGH TIME THAT THESE SCAMSTERS GET SHUT DOWN FOR GOOD

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aduse
Lubbock, US
Send a message
Jan 30, 2012 3:38 pm EST
Verified customer This complaint was posted by a verified customer. Learn more

I just wanted to say that I am having the very same problems in dealing with these company. I'm even on the phone as I write this awaiting their long hold times just to get through to a live person. I want all of you to be made aware that I will be hiring an attorney for a class action suit against these thiefs. Anyone who wishes to join me is more than welcome and I strongly urge all of you to jump onboard. Please email me at duse711@yahoo.com if you wish to be one of the parties involved for the initial filing of this suit. Thank you...

Note: still on hold...

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JJacques9
Cumberland, US
Send a message
Feb 02, 2012 11:47 pm EST
Verified customer This complaint was posted by a verified customer. Learn more

I am in the same boat. My situation is not as costly as most of yours but regardless, they scammed all of us. I say we get a class action suit going so we can stop these people and get out medical bills paid as promised

JDJ

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scoobydo
US
Send a message
Feb 14, 2012 2:55 am EST

Most people who are complaining here do not seem to respond to the officials from HCCMIS who seem to be offering help. Unless the intention is just to complaint, rather than find a solution, I suggest that everyone please reply to get your problems resolved.

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Cisimon
BE
Send a message
Apr 05, 2012 10:04 am EDT

Hello all, I was about to purchase short term insurance for my 23/y/o who is between college and grad school. I saw the HCC info and was thinking of getting 6 mo insurance... But fortunately your observations, warnings and complaints made me decide against it. Thank you. BTW.. with the gradual implementation of Obamacare, the gov has set up this very useful website http://www.healthcare.gov/index.html which has good tools to purchase insurance now, pending the changes with Obamacare.
I used it and got insurance for my daughter ( temporary) at a better rate than HCC.. besides insurer than post on this govt website need s to be vetted.. Best to all

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Cherryallen
US
Send a message
May 02, 2012 12:26 pm EDT

I got the same problem, , this company scam me and my husband!we going to sue them!

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Cherryallen
US
Send a message
May 02, 2012 12:37 pm EDT

Lets sue them!let sue them!they scaming me and my husband!now we need pay the hospital $20.000 dollar from our own pocket!

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vmj
dfsdfsdf, US
Send a message
May 16, 2012 3:02 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

I bought insurance for my father and for last 3 days he is suffering from sort of infection in his stomach. I have called most of the GPs which are mentioned on their web site. EVERY ONE OF THEM DECLINED THE INSURANCE. No one is willing to take PHCS or First health netowkr. I am really pissed off with HCC and called in their helpdesk and their attitude is pathetic and rude. Laura or whoso ever was there on desk said if doctor dont take insurance then we cant help it. This is frigging RIP OFF. I have paid insurance for 2 months and not worth even a single penny. I wish I have some money and SUE THIS SCAMSTER company. I have sent 10s of emails to HCC but their response is worst i have ever seen.

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TCV
US
Send a message
Jun 18, 2012 2:35 pm EDT

HCC Medical Insurance Services is fraud and scam. These guys are rude and cheaters. I have the same problem. my father cut his finger and I took to emergency room. I got a EOB with a reason code as the charges are related to mental health and/or substance abuse are not covered. That is BS. I paid 2K to buy the premium for parents...DO NOT BUY THIS INSURANCE. IT IS SCAM.

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isaacalves
BR
Send a message
Aug 02, 2012 9:26 am EDT
Verified customer This complaint was posted by a verified customer. Learn more

It really looks like it's SCAM. I cannot reach them, the phone numbers on the website or on their worldwide toll-free numbers sheet either don't work or belong to some other company. I've sent an e-mail and have not received any response so far.

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susan pramuk
Munster, US
Send a message
Aug 14, 2012 8:30 am EDT

please send me monthly cost to pay susan pramuk po box 3595 munster.ind i filled out form i want 2500 deductible with lower mth payments 80/20 ppo, [protected],

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Saheli
Stamford, US
Send a message
Sep 05, 2012 12:22 pm EDT

Please lodge your complain at https://www.ftccomplaintassistant.gov/ .At least make it black listed so that it cannot cheat others. I am also facing the same issues with this fraud company

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T. Charlon
Albuquerque, US
Send a message
Dec 28, 2012 4:27 am EST

For what its worth my husband went into hospital for a week (in France) which would have cost us nearly $2500 but after filing paperwork directly with the insurance company the hospital was paid directly. Because it took awhile (because I didn't get all of the paperwork in timely), I thought they were going to be a scam too -- but they paid up. They really did. So maybe go cautiously by reading all the small print but they kept their part of the bargain and I need to get insurance for him again so going with these guys a second time. I just hope his rates aren't higher because they've paid out once.

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Candace Moore
Bellevue, US
Send a message
Jul 03, 2013 12:14 am EDT

I have never been more disappointed or appalled by a company's lack of customer service, integrity or follow through. My fiances' parents came to visit for a few months and, since they are getting older, we decided to get them health insurance. Our biggest mistake was choosing HCC.
During phone calls we were given false information, such as prescriptions for pre-existing conditions would be covered, only to find out later that they were not. We were also given conflicting information from one phone call to another, even if they were back to back. Its as if the customer service reps know that they will not be held accountable for such errors or laziness and are in a rush to get you off of the phone.
I have spent countless hours on the phone trying to figure out what exactly is going on, only to be told that all is well and nothing needs to be done. When we started receiving billing statements from the physicians directly, I actually had to call them and explain that it was pending with the insurance company. Luckily, on more than one occasion, I was able to postpone us being charged off into collections. So, not only was I calling the insurance company repeatedly to find out what was missing, but also calling physicians to inform them of what paperwork to send, as well as sometimes having to physically go to their office and pick it up in order to fax it to HCC.
As if that isn't enough work, on top of paying already steep prices, now we are seeing that HCC has LIED repeatedly. Stating that they have not received paperwork, while i know it was sent and even have receipt confirmations for some of them. Sometimes, we will speak to one rep who says they are looking at the document, and then speak to another rep 2 days later, who says that nothing has been received. If HCC cannot insure quality assistance and consistence in a detail as simple as file keeping and organization, how are they to be trusted with anything?
We are now being billed ridiculous amounts, for injuries and illnesses that are CLEARLY covered by our policy, and as you can tell, we can't get a straight answer out of anyone as to why. If you are considering purchasing an insurance plan with HCC, I highly advise you to look elsewhere. Unless, of course, you enjoy the thrill of doing other peoples jobs for them, hunting people and information down for months at a time, and all to no avail, with the added bonus of a migraine or two.

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Scott W
US
Send a message
Jan 03, 2014 4:19 pm EST

Thanks for the info. I was just about to purchase the insurance when I found these posts. I will look elsewhere.

Scott

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J.A.O
Stock, US
Send a message
Mar 08, 2014 6:58 pm EST

I am currently attempting to get a trip to the emergency room covered by HCC and I am getting no where. I just came across this site and I now feel sick just reading these reviews. I have called HCC repeatedly and get told the same things everyone else has been reporting. They tell me my claim is processing. I got explanation of benefit forms in the mail saying all my claims were denied because they did not get my competent medical records from my doctor. I am now trying to get my records for HCC, but I am sure they will try to say my medical emergency was pre existing, which it was not. I am so angry. My hospital bills are probably about $6, 000. I thought purchasing short term major medical would prevent something like this from happening. I would never recommend this insurance to anyone. Buyer beware.

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romanv
SE
Send a message
Mar 20, 2014 8:37 am EDT

I also had such problem as Piyush Garg. This company sucks, never trust them! It is a group of scammers! I can provide al related documentation to prove that. I have written even on their twitter site. No reply!

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romanv
SE
Send a message
Apr 01, 2014 2:53 pm EDT

Please watch out the company called "insuremytrip" as well, as this company is selling their health insurance plans.

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S3K3R
Coupeville, US
Send a message
Jun 25, 2014 4:05 pm EDT

I've been dealing with this Company for the exact same reasons! I had a really bad stomach pain, which turned out to be gall bladder infection and needed to be removed... anyway, i went thru x ray, scans, etc... all this while visiting my sister in Sacramento, i bought this insurance just for my trip... now they refuse to pay...this happened in December 26th 2013, today is June 25th 2014 and nothing. tHIS COMPANY IS A SCAM... BEWARE!

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Bad Insurance
Chicago, US
Send a message
Nov 10, 2014 11:15 am EST

I am going through the exact same situation right now. We've mailed our claimant forms and have emailed our forms as well and they still can not locate them. I should have done my research as well! I'm contacting my attorney.

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preetambs
Alpharetta, US
Send a message
Nov 14, 2014 5:40 pm EST

This is a scam . They reject by writing Preexisting and wont get back also. Scam

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Amin_Ismaili
Middleburg Heights, US
Send a message
Dec 01, 2014 9:30 am EST

I purchased HCCMIS Atlas insurance online (their comprehensive, expensive plan) for my in-laws. My father-in-law got sick and we had to take him to urgent care on 06/02/2014. The urgent care directly billed HCCMIS. We thought all is good and settled until end of October or something when we received a mail from HCCMIS stating that our claim has been rejected because we failed to submit claimant authorization form of the patient within 60 days from date of service and they said they sent us blank claimant statement and authorization statement to us on 07/29/14, which we never received. So we requested them to reopen the case and sent us all required signed documents on 10/30/14 and on 11/09/14 we received e-mail confirmation from "Chana" who is a Client Relations Specialist that they have received all our documents. On 11/25/14 they sent us a mail telling that our claim has been rejected failing to send the claimant and authorization form and that they received it only on 11/18/2014 but the reality is they received it on 11/09/2014 (second lie, I have e-mail proof from their customer service specialist). I asked them to provide proof of delivery of the mail where they sent us blank claimant statement and authorization form and replied them back just now telling them that I am in full mood to file a legal complaint if required if this is not sorted out.

How am I as a customer at fault when I never received that claimant statement and authorization form in the mail? I am seriously disappointed with this company HCCMIS after paying hundreds of dollars in expensive insurance. Can someone help here?

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