SUBMIT A COMPLAINT

LOTSolutions / non-payment

1 P.O. Box 2066, Jacksonville, FL, United States Review updated:
Contact information:
Phone: 866-960-0772

after two years, now they won't send payment without knowing the reason for the Doctor visit, witch is very personal when I bought the Insurance through wells fargo witch take it out of my checking acount each month it just said for any doctor visit or dentist visit I send the print out from Kaiser perm. at the time I check in they charge me my copayment it has the time date doctor name why isint this enough it was for 2 years please help me make sence of this.thank you for letting me vent. yours truly Johnny Rocco, at [protected]@aol.com

Sort by: UpDate | Rating

Comments

  • An
      10th of Feb, 2011

    I Anna M Lambert policy # 49939612 & 49939695 formally request an administative review againt the Insurance Claims adjuster that handled my claim # 95475579.Company is Lots Solutions Program Administrations for National Union Fire Insurance Company of Pittsburgh, Pa P.O. Box 2066 Jacksonville, Fl. 32203-2066 The reason for said request is simple. It is appearent that said insurance claims adjuster is unable to do their job and they should be relieved from their position. I state this due to the fact that even the individuals from other departments were clearly able to obtain clients policy infromation and they were able to confirm the clients insurance policy type rather individual or family policy, this same infromation is assable to the Insurance claims adjuster if there were doing their job adequetly. It is appearent that the Insurance claims adjuster needs to be reevaluated by Administration to see it they should still be allowed the privledge of keeping their job since it appeart said individual lacks in the ability to do the job they were getting paid to do. The reason I have come to this aqusation against the Insurance claims adjuster is due to the issues I have when ever I have filled a claim and the most recient claim has caused me to file this complaint against the Insurance Claims Adjuster. Especially when the reason for the denial of said claim is due to the excuse of policy does not cover dependent, spouse or children for emergency room benefits, that alone shows DUE CAUSE for this request of Administrative review against Insurancve claims adjuster whom handled this claim # 95475579.


    Brief review:

    Customer Anna M Lambert request to file complaint againt Insurance claims adjuster for neglance of duty, Insurance claims adjuster has acces to insurance policy infromation and they denied a claim that was clearly ellidgable if the Insurance claims adjuster were doing their job accordingly. Customer had contacted customer service and claims service and those departments were able to verify and confirm that this policy #49939612 was indeed a Family policy and there was no excuse for this misunderstanding or denial of bennifits. So it is appearent that the Insurance claims adjuster was unable to do their job and perhaps someone else would be better suited for this position and more capable of doing this job. The Insurance claims adjuster whom handled claim number 95475579 represnts your company poorly, and needs to be retrained if you decide to allow that individual the privledge of keeping their job.


    Evidence;

    Enclosed as evidence is the customer complaint letter, copy of claims denial letter, copy of policy both policys due to the fact that the customer will probly have to send this letter again for the other policy due to the Incompidence of the Insurance claims adjuster if same Insurance claims adjuster handles both claims.

    +1 Votes
  • Ma
      1st of Apr, 2011

    I think that national union fire insurance company is a rip off. They lie and they don't send the money and this has been going on for over 6 wks. I have had enough.They were good for the first year now it is like pulling teeth to get the money. I have deciced that I am stopping my policy.

    +1 Votes
  • Av
      14th of Nov, 2011

    As of Today, 11/14/2011, I am almost in agreement with the previous policy holder #49939612--I have been having problems of 2 previous claims...they are sending Denial Ltrs (with wrong policy #'s on them -policy was terminated in 2008-Wrong last name, etc) also, when Denial ltrs are sent out, there is no DOS on them/only Clm #'s (usually wrong).I have faxed information over at least 5 times with "PROCEDURE CODES< DOS< DR"S INFO--I even went as far as to send them MEDICARE SUMMARY NOTICES..Definitely, the people at this place are not doing their jobs. I will however continue until they get it STRAIGHT!!! I really hate to go to a HIGHER power and make a complaint!! but I will if NECESSARY!!! I will give them until next week to GET IT RIGHT!!! info is sent by home fax machine, but everything is CLEAR (if anyone can read) You ask for DOS, Proc Codes, Diagnosis(not necessarily), AMT, etc...they should not be asking for any other personal information (HIPPA)...people GET IT TOGETHER!!!

    0 Votes
  • Bu
      9th of Jan, 2012

    I am going Thur the same thing. Have sent in 2 claims, with one coming back as denial. the other one they can't seem to get it right, very time I call, they say I have 10 claims in(wrong) then they say it takes 7-10 days, it has been over 3 months now. The lots solutions( who work for national fire) have very stupid people working for them. Can seem to be able to read.I have turned in a complaint to the bbb. Now that only took one day. wow some people can read. Sorry to seem very up set, but when you pay for a service you should get it.
    I am also turning in National fire insurance co. of Pittsburgh, pa. This is the company I took out the policy with Thur my homeowners. the Incompetence's of the Insurance claims adjuster, is also being turned in to the bbb They also will not let you speak to the insurance company them self.

    0 Votes
  • Av
      9th of Jan, 2012

    I finally got paid for my claims -even the one with Date of Service 11.7.11 (it was paid within a month)...I know how frustrating it is...because a customer service rep (people who we talk to//we're never allowd to speak to an actual "Claims' Adjuster) answers the phone they only tell you info they see from the claims adj...most of the reps know nothing about insurance and I do believe that some may not understand how to even read a claim--THE ONE WE SEND IN- But when I call I try to be respectful (and I call a lot-which is my privilege/right), realizing that I knw more about insurance claims than most (worked the field previously).. just remember / HONEY instead of VINEGAR!!! I have now sent 2 other claims in (they've approved-reasonable time lmt) and I do believe that when you are polite(even after 10 times(we shouldn't have to do this) they maybe a little more concern about your problems ..I seem to be getting my point across after speaking to the Reps!!!Let's see if sending my completed forms (with required info visible) thru the MAIL (instead of faxing) ..call me, and I will let you know a few other things. 8502616550

    0 Votes
  • My
      10th of Sep, 2012

    I AGREE THE COMPANY IS A RIPOFF AND BANK OF AMERICA NEEDS TO SEVERE ALL TIES WITH THEM. MY FATHER DIED IN A TRAGIC ACCIDENT, HE HAD THE ACCIDENTAL DEATH POLICY WITH THEM FOR YEARS. THIS COMPANY DEMANDED ALL THIS INFORMATION DEATH CERTICATE, AUTOPSY, TOXICOLOGY REPORT, NEWSPAPER CLIPPING, FUNERAL PROGRAM AND LASTLY A COPY OF THE INCIDENT REPORT FROM INVESTIGATORS. I TRAVELED SEVERAL TIMES TO HIS FORMER HOMETOWN TO OBTAIN THE CORRECT LATER REPORT. THIS CLAIM HAS BEEN UNDER REVIEW FOR OVER 6 MONTHS WITH WHAT THEY CALL UPPER MANAGEMENT WHICH IS A LAUGH. THIS COMPANY NEVER THOUGHT THAT THEY WOULD HAVE TO DO A PAYOUT ON A ACCIDENTAL DEATH POLICY BECAUSE FROM WHAT I HAVE RESEARCHED JUST THE WRONG WORDING FROM A CORONER COULD DENY A PAYOUT, WITH THIS CLAIM THEY COULDNT FIND ONE SO THEY ARE STALLING TO PAY OUT.

    0 Votes
  • Ro
      7th of Jun, 2013

    we are in agreement. They keep saying they need more information and when we send more they want stuff that has already be sent. They even said they did not have the information and did not know where it is. We reminded them about the laws about privacy and that they are responsible for the information they receive. They just say I know. They do not return calls and always come up with different things or want stuff that has been send over and over again. They have even said the er is out pt and when I have to stay there a week after being in the er that it is out pt too. I too think this is a rip of program and something needs to be done to stop them from fulfilling their end of the bargain. Ron Clayton

    0 Votes
  • Ma
      19th of Aug, 2015

    I submitted claim for our mother that passed away in December of 2014. They sent the check but had it addressed to the estate of our mother. Our mother did not have and estate she owned nothing except her car that she had taken out the insurance on. I have sent to the company all of the documents that they have requested and they are just avoiding my call and not returning any of my calls. My next step is going to be the BBB and the news channels.

    0 Votes
  • Ki
      16th of Oct, 2015

    I have recently filed a claim with the company for disability payments in May2015 from the beginning it was excuses of paperwork not received; doctor will not send records, my forms were not received. To its under review. Then no return calls, not allowed to speak with underwriter. No communication at all. So at the end of Sept. I sent a complaint to their office for not processing my claim and they sent me a denial.

    Can someone tell me what agency I start my complaint with?

    0 Votes

Post your comment