American Progressive / Medical Insurance Fraud
P.O. Box 742648
Houston, Texas 77274
Complaint against American Progressive
Call was made at 3:30PM by Patricia Prior regarding explanation of benefits reference number [protected].
I am going to describe in detail what just happened with the medical insurance company American Progressive.
My mother received a call from Dr. Shalom J. Kieval’s office. His address is the following: 223 Great Oaks Boulevard; Albany, New York 12203. The phone number is [protected]. They contacted my mother at 3:20PM on February 22, 2008 at her home and told her that they tried to submit a claim on her last office visit and they were told that “Patricia Prior’s” insurance had been “terminated”. My mother got very concerned an IMMEDIATELY called American Progressive at the phone number listed above. She was told she would “have an answer in 72 hours”. Then my mother called me at my home in Saugerties, New York at the number listed above. She explained to me the situation as stated. I was very upset and decided to call them myself which I have done before. I called on July 23, 2007 at 11:10AM and spoke to a “Linda” about a bill that was sent to my mother’s house regarding the same doctor’s office. The situation with that bill was that they claimed “the $1600.00 bill sent to Patricia Prior was NOT A BILL.” They stated that “they received the referral late”. I thought nothing of it at the time since the issue was resolved immediately.
I called (Keli Kane) with my mother also present on the phone on three-way calling to American Progressive on February 22, 2008 after my mother called me. I called the company at exactly 3:47PM. Here is how the phone call went.
A person named “Raymond” answered the phone but it was DEFINITELY a woman. I first asked to speak to a supervisor and she denied me that opportunity. She was adamant about taking to me first. I told her that this is not the first time we have called today, and that I have called in the past about a problem with their company on 7/23/07. She asked me for a reference number for the phone call. I told her all the information that I had (which I stated in the letter already above). I then asked her for the “reference number” for this phone call. She gave me the following number: [protected]. She asked me my name, my phone number, and then “pulled up records”. She asked for the last four digits of my mother’s social security and my mother responded directly to that question. Then she told me that she was going to transfer me to a supervisor and put us on hold. However, she got right back on the phone again. She asked us when Patricia’s last office visit was. My mother told us the last visit was on January 16, 2008. Then we could hear her typing all of this information into the computer. Then she came back on the phone and stated the obvious to us again which was “there is no definite reason it was terminated”. Then “Raymond” asked my mother to explain what was exactly said to her when Dr. Keival’s office called her today. Dr. Keival’s office told my mother that they tried to submit a claim and they were informed that she no longer had insurance because it was “terminated”. Then “Raymond” allegedly looked up the phone call to “Linda” on 7/23/07 at 11:10AM. “Raymond” put us on hold for a moment to “check the situation”. We were on hold from 3:37PM to 3:58PM. She then got back on the phone and stated that the situation was “already sent to the highest priority”. This is where I cut in and became extremely firm with “Raymond” and DEMANDED to speak to a “supervisor” immediately. The she stated “hold on, we’re double checking on this”. She put the call on hold again from 3:59PM to 4:05PM. Then “Raymond” came back on the phone again. She asked AGAIN the date of service last obtained from Dr. Keival’s office which was 1/16/08 which had a remaining bill of $560. Raymond stated “$560 EVEN?” She asked if she received a “benefits explanation”. The she asked for the claim number on the form which was reference number [protected]. She then put us on hold AGAIN at 4:08PM until 4:12PM. She briefly came back on to ask for more time and then we went back on hold again until 4:13PM. At this point I am IRATE! You have to be joking that an insurance company can cash your check for services, and then “terminate” your insurance for “NO DEFINITE REASON” and then ask US to wait 72 HOURS for the answer. So wait, it gets better!
“Kayla” gets on the phone acting as a “supervisor” at 4:18PM. She tells me that same information. “This call has already been sent to the highest priority”. I cut her off and started yelling because at this point they are playing games. This is a hoax that insurance companies do. It’s ploy because MOST people will give up and lose their money. I’m not one of those people. There’s no person or company in the world that is going to take advantage of any family member of mine. I will expose this company to every company that will record complaints. “Kayla” refused to give me an address to file a complaint. I literally had to scream the request at her FOUR TIMES. On the fifth time I threatened to call the police because at this point something is very “shady” with this company. She then gave me the following correspondence: P.O. Box 742648; Houston, Texas 77274. Then I requested a fax number and she actually mocked me in tone. Then I threatened her mocking tone and she quickly stopped once she heard who and what I was doing with all of this information. I am going to go so far as to get a lawyer and request that phone conversation and post it with the news. I AM NOT JOKING!! I am a Reading Specialist who is very determined NOT to be taken advantage of by your company. The fax number given to me was: [protected]. I will be checking with the authorities to see who this company is, and who has been cashing my mother’s checks.
If you respond IMMEDIATELY with the information that we are looking for right away I will not file this complaint. I am only waiting until 7PM and then hitting the send button to any complaint board that I can access, and quickly copy and paste the complaint it.
How dare you try to take advantage of older people. How many others are you doing this to? Be VERY SURE that I will find out, and see who wants to join me on the fight against your company. I’ll be sitting here waiting for your response. If I get nothing, expect more from bunches of other companies investigating you.
Also…Here is just one other complaint I found on you so far.
Posted: 2008-01-16 by Kate Bielec [send email]
Scam and fraud!
PO Box 742648
My father moved in September. I called American Progressive and Medicare with his change of address. He received all kinds of correspondence from American Progressive. On December 3rd we received a letter thanking him for keep his insurance for another year and received new insurance card. Later on that month we order some of his medical supplies, the supply company told us he no longer had insurance. I called American Progressive and was told by the customer support supervisor that he was canceled because they never received a form in writing that he had moved and that was a policy of Medicare not theirs. They mailed the form out Novermber 8th ( he was canceled Nov 30th) . We never received the form and I told the supervisor and all she would say is that they never received it and it was Medicare Rule not theirs. When I called Medicare, the supervisor said it was ludigress and had never hear of anything like that. My father also signed up for the plan that would pay him $200.00 a day while he was in the hospital. He was in the Hospital for 11 days and still has not received a check. The Customer Support Supervisor said they didn't get the information in the mail, no matter how many times we have mailed it out. Seems strange that we can not receive something they send and it's ok to cancel the policy, but it's ok if they don't received our letters so they don't have to pay.
Be careful when you go through this insurance company, we have found out that they are so bad with customer complaints to medicare they couldn't sell insurance in New York State for 2 years.