HCC Health Insurance (HCCMIS) / Health insurance

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HCC Medical Insurance is running what appears to be a deliberate scam on consumers.

HCC appears to do everything possible to avoid paying on claims. Below are some illustrative examples but are no means complete:

1/ Constantly claiming that information that was sent was "never received". In the case of one document, the provider sent it four (!) times and HCC kept claiming it was never received. I asked for an address that I could send it myself by fedex to ensure that it was received and was told this was impossible. I asked for a fax number so I could have confirmation and was told this was impossible. When i threatened HCC with a formal complaint followed by IMR, they miraculously "found" the documents. This has happened with every single document submitted - HCC's first response is always, invariably, they don't have it. This appears to be a deliberate fraud on consumers to make it impossible for them to file a claim.

2/ Provide inaccurate information and then do not stand behind their employees' commitments. When I signed up for the plan, I was told it was an indemnity plan and that I should pay providers for medical expenses incurred and then submit to HCC for reimbursement. Several months later, when it comes time to process claims, I was told that this is not the case and that HCC would not honor its employee's commitment. This has cost me several thousand dollars (the difference between the "negotiated rate" that HCC is willing to pay providers and what providers actually charge). This negotiated rate was never disclosed to me at any time, nor was I ever mailed a guide to the program.

3/ Delays beyond a reasonable scope. HCC claims to resolve claims within 30 days. However, none of my claims ever advanced at all without me calling to intervene and jump through several hoops. We are now in November, my claims were submitted in June, and we are no further ahead. This appears to be deliberate policy to exhaust consumers' patience so that HCC doesn't have to pay.

4/ Payout to the wrong entities. Despite the fact that HCC knew that I paid providers directly for medical work - acting on HCC's specific and clear instructions - they refuse to reimburse me but are reimbursing providers instead, knowing that it will be next to impossible for me to get providers' attention and ask them to issue checks to me commensurate with their reimbursement from HCC.

Nov 09, 2016

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