Tokio Marine HCC Medical Insurance Services Group / HCCMIS.com review: Claim non-fullfilment 50

I had to go to the hospital last October due to a sciatica. They treated me at the hospital and told me they would contact the insurance company and I didnt have to worry about anything. Due to my working visa expiration, I flew back to Spain in November and now that I am back in the US, I have been said, I have to pay for that treatment cause I didnt send the claims on time. Why should I be paying a 1000$ insurance if I have to pay for the treatment cause I wasnt able to send the forms and claims earlier?

Horrible service, you end up paying everything out of pocket even though you are supposedly "covered". STAY AWAY PLEASE!

Your experience sounds exactly the same as mine: many many hours on the phone with HCC trying to figure out why claims weren't being paid. Back and forth with doctors' records and being told they hadn't received them. On and on and on, until finally, after 9 months of this, they denied everything and closed the file, claiming they hadn't received records! They re-opened file, the gastroenterologist sent records (again!), and within days they denied ALL my claims related to this procedure -- lab, hospital, everything. $15, 000 worth of bills! It took them 11 months to do all this. They claimed I had a pre-existing condition of diverticulitis, which I never had. What I can glean at this point, is that they could find no PE condition based on my primary care doctor's records (55 pages that she had to send twice!) so they contacted the gastro doc to see if they could find something in his records. Since this was the first I went to see this doc, he has no history, only the issues I presented upon seeing him for the first time. HCC then used the excuse that they hadn't received records so that they could deny claims. When that didn't work because I had my doc send records again, they came up with "diverticulitis", which, it turns out, has nothing at all to do with my symptoms even if I HAD ever had it! I don't even know where they got this from. Needless to say, we are definitely filing a complaint with the NAIC and will sue this company to get our money back and more. THEY ARE A SCAM, and I have to wonder how they ever got a license. And don't you just love the phony British voice that picks up each time, I suppose they think that gives them some sort of prestige. We subsequently purchased a plan from United Healthcare when we saw HCC was dishonest. We haven't had a single issue with United Healthcare.

Had this HCC insurance back in 2014, a complete scam, a horrible experience.
Drop this insurance as fast as you can, they pay nothing!

Even my parent's claim was denied by HCC falsely. I raised a complaint with
New Jersey Department of Banking and Insurance - Consumer Inquiry and Response Center ("CIRC").

Waiting for resolution on this.

Stay away at all cost! Complete scam. Wont pay anything to any doctor or services.
They will close your case because you did not respond on their letter they claiming they sent you 3 months before case was closed. Of course there was no letters send. Just scammers!

I had HCC for 6 months. Used them 2 times and they would not pay anything for me. In my opinion they are CROOKS! They did not hesitate to take my money every single month. They would not even pay for bloodwork for me. They said they do not pay for pre-existing OR routine. So what else is there if it's not pre-existing or routine? In other words...WE TAKE YOUR MONEY, BUT WE DO NOT PAY! Everyone that has posted on this thread posted for a reason because these people are CROOKS!

Exact same situation as Amin Ismaili. Had taken this insurance for my mother and all I have been hearing over the months was, we did not receive claim authorization form. After 15 or so calls and dodging, finally I receive mails saying that the claim has been closed due to lack of requested information and the claim is now past the contract's timely filing guidelines. An progress on the class action law suit?

Hi Took my parents insurance through HCC and emergency condition happened for my Dad. My dad's endoscopy done by doctor before providing any medication. HCC is not paying my claim and they are saying it is pre existing condition and they will not provide my claim. Doctors office is following up for bills paid. If we contact HCC they are not talking and giving proper reasons. FRUSTRATED with HCC, please BEWARE do not buy insurance from this company at all...

Exact same situation here. These guys seem to be fraud and looking for every opportunity not to pay. Working with a lawyer on class action lawsuit. Will let you all know. In the meantime if anyone already picked up class action law suit let me know and we will join

I purchased HCCMIS Atlas insurance online (their comprehensive, expensive plan) for my in-laws. My father-in-law got sick and we had to take him to urgent care on 06/02/2014. The urgent care directly billed HCCMIS. We thought all is good and settled until end of October or something when we received a mail from HCCMIS stating that our claim has been rejected because we failed to submit claimant authorization form of the patient within 60 days from date of service and they said they sent us blank claimant statement and authorization statement to us on 07/29/14, which we never received. So we requested them to reopen the case and sent us all required signed documents on 10/30/14 and on 11/09/14 we received e-mail confirmation from "Chana" who is a Client Relations Specialist that they have received all our documents. On 11/25/14 they sent us a mail telling that our claim has been rejected failing to send the claimant and authorization form and that they received it only on 11/18/2014 but the reality is they received it on 11/09/2014 (second lie, I have e-mail proof from their customer service specialist). I asked them to provide proof of delivery of the mail where they sent us blank claimant statement and authorization form and replied them back just now telling them that I am in full mood to file a legal complaint if required if this is not sorted out.

How am I as a customer at fault when I never received that claimant statement and authorization form in the mail? I am seriously disappointed with this company HCCMIS after paying hundreds of dollars in expensive insurance. Can someone help here?

This is a scam . They reject by writing Preexisting and wont get back also. Scam

I am going through the exact same situation right now. We've mailed our claimant forms and have emailed our forms as well and they still can not locate them. I should have done my research as well! I'm contacting my attorney.

I've been dealing with this Company for the exact same reasons! I had a really bad stomach pain, which turned out to be gall bladder infection and needed to be removed... anyway, i went thru x ray, scans, etc... all this while visiting my sister in Sacramento, i bought this insurance just for my trip... now they refuse to pay...this happened in December 26th 2013, today is June 25th 2014 and nothing. tHIS COMPANY IS A SCAM... BEWARE!

Please watch out the company called "insuremytrip" as well, as this company is selling their health insurance plans.

I also had such problem as Piyush Garg. This company sucks, never trust them! It is a group of scammers! I can provide al related documentation to prove that. I have written even on their twitter site. No reply!

I am currently attempting to get a trip to the emergency room covered by HCC and I am getting no where. I just came across this site and I now feel sick just reading these reviews. I have called HCC repeatedly and get told the same things everyone else has been reporting. They tell me my claim is processing. I got explanation of benefit forms in the mail saying all my claims were denied because they did not get my competent medical records from my doctor. I am now trying to get my records for HCC, but I am sure they will try to say my medical emergency was pre existing, which it was not. I am so angry. My hospital bills are probably about $6, 000. I thought purchasing short term major medical would prevent something like this from happening. I would never recommend this insurance to anyone. Buyer beware.

Thanks for the info. I was just about to purchase the insurance when I found these posts. I will look elsewhere.

Scott

I have never been more disappointed or appalled by a company's lack of customer service, integrity or follow through. My fiances' parents came to visit for a few months and, since they are getting older, we decided to get them health insurance. Our biggest mistake was choosing HCC.
During phone calls we were given false information, such as prescriptions for pre-existing conditions would be covered, only to find out later that they were not. We were also given conflicting information from one phone call to another, even if they were back to back. Its as if the customer service reps know that they will not be held accountable for such errors or laziness and are in a rush to get you off of the phone.
I have spent countless hours on the phone trying to figure out what exactly is going on, only to be told that all is well and nothing needs to be done. When we started receiving billing statements from the physicians directly, I actually had to call them and explain that it was pending with the insurance company. Luckily, on more than one occasion, I was able to postpone us being charged off into collections. So, not only was I calling the insurance company repeatedly to find out what was missing, but also calling physicians to inform them of what paperwork to send, as well as sometimes having to physically go to their office and pick it up in order to fax it to HCC.
As if that isn't enough work, on top of paying already steep prices, now we are seeing that HCC has LIED repeatedly. Stating that they have not received paperwork, while i know it was sent and even have receipt confirmations for some of them. Sometimes, we will speak to one rep who says they are looking at the document, and then speak to another rep 2 days later, who says that nothing has been received. If HCC cannot insure quality assistance and consistence in a detail as simple as file keeping and organization, how are they to be trusted with anything?
We are now being billed ridiculous amounts, for injuries and illnesses that are CLEARLY covered by our policy, and as you can tell, we can't get a straight answer out of anyone as to why. If you are considering purchasing an insurance plan with HCC, I highly advise you to look elsewhere. Unless, of course, you enjoy the thrill of doing other peoples jobs for them, hunting people and information down for months at a time, and all to no avail, with the added bonus of a migraine or two.

For what its worth my husband went into hospital for a week (in France) which would have cost us nearly $2500 but after filing paperwork directly with the insurance company the hospital was paid directly. Because it took awhile (because I didn't get all of the paperwork in timely), I thought they were going to be a scam too -- but they paid up. They really did. So maybe go cautiously by reading all the small print but they kept their part of the bargain and I need to get insurance for him again so going with these guys a second time. I just hope his rates aren't higher because they've paid out once.

Please lodge your complain at https://www.ftccomplaintassistant.gov/ .At least make it black listed so that it cannot cheat others. I am also facing the same issues with this fraud company

please send me monthly cost to pay susan pramuk po box 3595 munster.ind i filled out form i want 2500 deductible with lower mth payments 80/20 ppo, [protected],

It really looks like it's SCAM. I cannot reach them, the phone numbers on the website or on their worldwide toll-free numbers sheet either don't work or belong to some other company. I've sent an e-mail and have not received any response so far.

HCC Medical Insurance Services is fraud and scam. These guys are rude and cheaters. I have the same problem. my father cut his finger and I took to emergency room. I got a EOB with a reason code as the charges are related to mental health and/or substance abuse are not covered. That is BS. I paid 2K to buy the premium for parents...DO NOT BUY THIS INSURANCE. IT IS SCAM.

I bought insurance for my father and for last 3 days he is suffering from sort of infection in his stomach. I have called most of the GPs which are mentioned on their web site. EVERY ONE OF THEM DECLINED THE INSURANCE. No one is willing to take PHCS or First health netowkr. I am really pissed off with HCC and called in their helpdesk and their attitude is pathetic and rude. Laura or whoso ever was there on desk said if doctor dont take insurance then we cant help it. This is frigging RIP OFF. I have paid insurance for 2 months and not worth even a single penny. I wish I have some money and SUE THIS SCAMSTER company. I have sent 10s of emails to HCC but their response is worst i have ever seen.

Lets sue them!let sue them!they scaming me and my husband!now we need pay the hospital $20.000 dollar from our own pocket!

I got the same problem, , this company scam me and my husband!we going to sue them!

Hello all, I was about to purchase short term insurance for my 23/y/o who is between college and grad school. I saw the HCC info and was thinking of getting 6 mo insurance... But fortunately your observations, warnings and complaints made me decide against it. Thank you. BTW.. with the gradual implementation of Obamacare, the gov has set up this very useful website http://www.healthcare.gov/index.html which has good tools to purchase insurance now, pending the changes with Obamacare.
I used it and got insurance for my daughter ( temporary) at a better rate than HCC.. besides insurer than post on this govt website need s to be vetted.. Best to all

Most people who are complaining here do not seem to respond to the officials from HCCMIS who seem to be offering help. Unless the intention is just to complaint, rather than find a solution, I suggest that everyone please reply to get your problems resolved.

I am in the same boat. My situation is not as costly as most of yours but regardless, they scammed all of us. I say we get a class action suit going so we can stop these people and get out medical bills paid as promised

JDJ

I just wanted to say that I am having the very same problems in dealing with these company. I'm even on the phone as I write this awaiting their long hold times just to get through to a live person. I want all of you to be made aware that I will be hiring an attorney for a class action suit against these thiefs. Anyone who wishes to join me is more than welcome and I strongly urge all of you to jump onboard. Please email me at duse711@yahoo.com if you wish to be one of the parties involved for the initial filing of this suit. Thank you...

Note: still on hold...

IF ANYONE CONSIDERS A CLASS ACTION AGAINST THESE THUGS I AM READY .. IT IS HIGH TIME THAT THESE SCAMSTERS GET SHUT DOWN FOR GOOD

Muhammad Yasin, the client services manager, YOU GUYS ARE THUGS AND SCAMSTERS, AND YOUR GREEDY COMPANY SHOULD BE SHUT DOWN IMMEDIATELY AND ALL OF YOU SHOULD BE SENT TO JAIL FOR DEFRAUDING PEOPLE, BY TAKING HIGH PREMIUMS FROM UN-SUSPECTING PEOPLE AND THEN REFUSING TO PAY FOR EVEN AN X-RAY, HOW CHEAP CAN YOU GUYS CAN BE ? I SINCERELY HOPE THAT FEDS SHUT YOUR SCAM SHOP DOWN

These guys are scamsters, thugs and cheats, they took a premium of 1000 dollars and refuse to pay anything, they word their policies in a slick way that they exonerate themselves from any payment, they should be sued in federal court for malpractice and should be shut down for good

I completely agree these guys are scamsters, they took 1000 dollars in premium and refuse to pay anything .. they should be sued in federal court for insurnace malpractice and fraud

I am also having similar kind of experience what have been stated by others. I purchased insurance for my father who visited me from India. My father got his shoulder sprained due to a minor injury. After doing X-ray/ City Scan, physician determined the problem due to 'Shoulder Impingement' and my dad took physical therapy sessions for the same. HCC Medical kept on dragging the claims for 5 months for one reason or another. I sent them my father's authorization for processing the claims through all possible means in current world - Email/ Mail Post/ Fax. Thereafter, they kept saying that they are waiting for medical records from physician. However, I found that physician has sent everything and they kept telling physician that they are waiting for my father's authorization. And finally after 5-6 months of back and froth, they denied all claims citing as 'Pre Existing condition'. I wonder how could an injury be a pre-existing. To put it in simple words, they are in business of fleecing people in a very systematic manner. I consider myself unfortunate that I didn't check their reviews before buying the insurance. One more thing which I noticed is regarding their Target Customers. Most of the cases where such cases happen are those when person is from a different country and would definitely go back in sometime and there would be very less complaints in such cases. I would request the sufferers to spread the word around (by all possible mediums) so that no one else get cheated and I myself will surely do it.
My father's id: A9471858

I work for a doctors office and there is a patient that has this insurance and we are getting the same run around! BUYERS BEWARE! We have sent records multiple times and finally the HCC Medical denied the claims as timely...I will be contacting the Department of Insurnace and reporting this company.

I strongly agree with Peeyush and Divya and warn everyone who is planning to buy insurance from HCC. We bought insurance from them when our In-laws visited us this year. In May 2011, my father in law got fainted one day and when we went to hospital they said he has had stroke. He was air lifted to the nearest big hospital and was admitted for 5-7 days. We started contacting HCC since day 1 and informed them about the entire situation. Once he came back home, we started getting various bills which went on and on for months. We made numerous calls to HCC checking about the status and every time we were told that additional information requested from service provider. On day we got a call from Mercy St John’s that they are referring our case to credit agencies due to late payments. We told them that HCC has asked additional information from you and hospital said we have already given everything months back and now we had to report this to credit agencies. Somehow we connected both of them together and resolved this mess. Now last week HCC has sent us a bill of $47, 000 denying everything saying Pre-existing condition as a reason. I wonder how can a stroke be a pre-existing condition? This firm is a complete fraud and now we are discussing with attorneys to help us out.
Beware never but anything from them. They are complete fraud.

I am also one of the aggrieved. I submitted 2 bills one for consultation $100 and another medicines for $30. The worst insurance company HCCMIS made all attempts not to pay. First, they said that they did not receive medical records from physician. When doctor sent again, they disallowed both biils. They always say and write to send itemized bills. Receipt of doctor for consultation charges is not adequate to them. Bills of CVS pharmacy are not sufficient. Every time, call is made they say, "Send itemized details", like a parrot. They want to avoid to make a small payment of $30 even as the first $100 I paid goes towards deductible, which they do not want to treat.
This is the worst insurance company I have come across, so cheap company to avoid even $30.
I feel I could have seen the numerous worst reviews of this company. On phone, they keep us hanging for hours to make us disconnect and drop the claim. They do not allow the aggrieved to speak to their higher authority even. Worst ever had this type of experience.
As a professor, I tell my students what worst experience I had. Students are the best agents to propagate this company to sink.
This is a first class scam company in USA.
My ID # IM [protected].
iNSURED: CHEKKA RAMA GOPAL

Thank god I saw this. will never buy from this SCAM artists..