Cinergy Health / Misrepresentation in Sales process
1. The salesperson misrepresented the information about coverage and about the facts about my current health insurance:
a. The salesperson said that Chiropractic Care was covered in the plan. When I went to use my insurance for Chiropractic care, I was told on the phone that Chiropractic Care was not covered and only covered one office visit not including any manipulation.
b. I was told by the salesperson that under my current health insurance that that if I were to go into surgery that I would have to pay for my deductible first or the hospital would not treat me. I was told that I would not necessarily have to pay for the 10% co-pay to the hospital for surgery under Cinergy because deductibles are paid in advance and that the hospitals would not deny surgery under Cinergy. I just found out that this is not true that my hospital would work with me on a payment plan under my current plan.
c. The advertisement on T.V. was misleading saying there were no high deductibles but in fact I would be responsible for 10% of the surgeries is potentially be more than the deductible that I currently have. When I asked the salesperson about the claims on TV, he inferred that I would not really have to pay for the 10% because the hospital would have to come after me after they treated me. I told him, but I was still responsible, and he argued with me and repeatedly said that I didn’t have to pay it up front and get denied.
d. The advertisement on T.V. also said that I could get the insurance with pre-medical conditions, but the information in the documents stated that I would not be covered for pre-medical conditions and any claim within 30 days would be reviewed.
e.. I asked if having Cinergy Health Plan would cover me for any medical issues that come up, he said yes, but in fact has a cap on coverage. I asked if I should have additional coverage. He said no and offered the critical illness plan instead for $46/month. When I inquired about canceling the representative said that I was exempt from receiving money back because the insurance is considered supplemental insurance and is not enough insurance to cover for primary insurance. That is contrary to what the salesperson said. Later when I made a formal complaint, they again stated it was something different.
Lastly, Cinergy Health did not return the full amount of the 2 months of insurance that I had paid. (1 month pre-paid), and when I asked what the process to contest the refund was told to go to my states Insurance Commissioner and make a complaint.
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