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I, Harvey L ONeal, purchased a cancer policy from AIL in August 2008. The policy and its ramnifications of its lack of benefits was never explained to me by the Insurance Agent Ms. Julie Hallgren, CA Insurance Agent Licenser H2975. She seemed to only want to sell an insurance policy as extreme pressure is applied to AIL sales agents to sell policies as witnessed on the internet by AIL hiring policies.
When I received the policy, it had a twenty unit limitation me3aning the kidney cancer surgery benefit of .51 was multip[lied by the .0 units in the policy as a conversion facter. As a layman consumer I had no idea nor was this explained to me by Ms. Hallgren of the implications on future benefits until I had kidney cancer surgery Nov. 10, 2009. When I filed for benefits, which arrived 4 months later AIL paid $1, 630 on a kidney cancer surgery and 2 day hospitalization on the total cost of surgery/hospitalization of well over $56, 000.00. This is UNACCEPTABLE, UNFORGIVING AND TOTALLY ABSURD. AIL cancer benefits in their cancer policies do not even come close to meeting the costs of todays escalating hospitalization/surgery costs. Their conversion factors built into cancer policies are there to limit their future liability in paying future benefits. Believe me, you will be deeply disappointed in their benefit package and you will be overwhelmed with medical costs AIL will not pay.
Thank you.
Whoops, I accidentally hit send.
If you started your policy in August of 2008 and you contracted cancer in in November 2009 then you paid (assuming you paid 20 a month) 15 months of premiums which would equal at most $300 dollars total. The company paid you for the surgery $1, 600 and 400 more for the 2 days in hospital so a total of $2, 000 dollars.
On a policy that is supplemental to health insurance for cancer (which means you should have health insurance and this will just cover the EXTRA expenses not the 'coinsurance aspect')in where you paid out a total of $300.00 in the 15 months you had it and the company paid you just over $2, 000.00...
The conversion factors are not there to limit their ability to pay claims effectively in the future. they are there because you should have already had other health insurance, maybe even some other cancer insurance coverages. But, by the sound of your post, you did not. That is not AIL's problem, that is your problem. I do feel sorry that you have so much medical bills and leftover stuff.
If you did not have any health insurance, you should have let the agent know, at that point. The agent would have sold you what is commonly known as a "lump sum cancer" policy. You would have been paid $25, 000 at first diagnosis of cancer, and the type of cancer does not matter (unless skin cancer, because that's not covered). This policy is obviously more a month, which a reason you bought the "per proceedure cancer policy" (listed above in the previous post) because it's a lot cheaper, and covers very basic aspects and generally speaking (unless you have a terminal or very major internal cancer) pays modestly and not intended to pay off all your medical bills.
So, to sum it up.
You paid 300 dollars for the whole time owning the policy
The company paid you more than 2000 dollars off of one claim.
Your policy is a max coverage of $100, 200 which means that at this rate you can make close to 100 more claims at the same rate.
Or 1 major claim that is going to pay out the 98, 000.
For 20 dollars a month, i'd consider that a deal.
If you want more coverage though, I hear Blue cross blue shield has a great plan. It only costs 500 a month for decent coverage. Humana has even better coverage (depending on your needs) for 800 a month for less healthy people.
P.s. I don't mean to be a jerk in this post, but if you are making money from making a claim, i don't see what the point of complaining about. Without this policy that you paid 20 a month for, you'd have 2, 000 coming out of your own pocket. I, personally, would rather pay 20 a month.
I hope you realize that American Income Life is a life insurance company. they are not a health insurance company. a 20 unit cancer policy pays as follows
Hospital: ($200 a day for twelve days and 100 a day thereafter)
For a total "maximum benefit" of $74, 200 of benefits
Surgical: ($90.00 to $1, 500 per operation as outlined in schedule of operations[refer to policy])
For a total pay out of $10, 000
Anesthesia: Not to exceed $200 per operation)
for a total of $2, 000 of benefits
Radiation Therapy and Chemotherapy (Usual & customary charges)
For a total of $4, 000 of maximum benefit
Nursing (80.00 a day when required)
For a total of $4, 000 of maximum benefit
Attending Physician ($40.00 a Day)
for $2, 000 maximum benefit
Blood Plasma (Usual and customary charge
for $2, 000 maximum benefit
Ambulance
For a maximum $1, 000 benefit
Transportation
1, 000 for maximum benefit
Which totals out to being $100, 200 of total coverage
On top of that they have an extended benefit which is in lieu of hospital benefits on the 91st day at the begining of the next month they will send $12, 000 a month to the family which has absolutely no maximum limit.
This is a breakdown of what your 20 unit cancer covers. The actual monthly costs that you incurred based on your age. would have been anywhere from 3 dollars a month to a maximum of about 20 dollars a month... and that 20 dollars a month is covering 70's males.