i have been waiting 4 months so far, for Combined Life to review my claims on their accident plan.
i was told by an employee that if i filed more than 2 or 3 claims in a month, that i WOULD be kept waiting. at first they had sent me a letter requiring that the doctor fill out the back of the claim form.
then i got a release form in the mail for each one of my claims, that i had to sign, allowing them to review my medical records. when documents were mailed from the medical facility, it took them 3 or 4 weeks to acknowledge that they were received. But then i was told that they weren't received. And then i was told that they were received but they were still missing something. And then i was told that they didn't believe that the medical facility actually sent the medical records; they thought that i had mailed them.
WHY? because the documents contained the very same information that i used to mail them: no more, no less. they didn't bother to look at the envelope and the mail room stamp? and then they said they spoke with the facility and it was clarified that it came from them. but then a second time, they said that they had to check with the facility to find out exactly who had mailed them... then they told me that they didn't receive the documents from the second medical facility and they wouldn't review any of my claims until ALL the medical records were received from both facilities for the year 2006.
when they received the medical records from the second facility, then they said that they didn't receive everything they needed from the first facility. they told me that 1 of the claims i had submitted from the second facility was in fact grouped together with those of the first facility. and since they were only going to now review the claims from the second facility (2 claims out of 11), 9 claims will continue to remain pending for further information. furthermore, out of the 11 claims submitted to them, they are reviewing only 1 at this time and i might be waiting 5 months for them to review the second claim.
Owego, New York