- Report: #773529
Report - Rebuttal - Arbitrate
Complaint Review: Conseco Health Insurance Company
Conseco Health Insurance Company11815 N Pennsylvania Street Carmel, Indiana United States of America
Conseco Health Insurance Company Refuses to pay lump sum due per policy, refuses to give explanation Carmel, Indiana
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I faxed all of this information by filling out the claim forms provided by the company on 8-24-11 at 11:10am. I received a letter dated 8-26-2011 but postmarked 09-1-2011 from the company stating that "Your accident insurance pays benefits only when the sole cuase of loss is accidental bodily injury. The information we have shows that there were other causes for this loss. The description of the incident does not meet the definition of an accident/accidental injury as outlined by your policy."
My wife called the 800 number listed on the policy and spoke with three different people. The first was a female who could only repeat what the letter said and give no clarification, my wife then spoke to a man who said it was not an accident because the defintion of an accident is "unforeseeable" and my accident was foreseeable. She asked him how that was possible because I have been a farmer all my life and have never had this happen and moving auger hoppers is routine. He kept repeating himself.
My wife asked for a supervisor and he told her there were none. SHe said he would find one immediately as he was unable to answer her questions. HE did find one. The supervisor said it was not an accident because it was "aviodable". My wife asked how it was aviodable and he said I did not have to lift the auger hopper. She said that millions of people lift auger hoppers every day and bicep tendon does not rupture, that it was an accident. She then asked how I was supposed to the hopper and he just continued to repeat that she needed to file an appeal because what happened was avoidable.
I have since filed a complaint with the insurance commission of Indiana, the insurance commission of South Dakota and BBB. I will file the appeal tomorrow morning via fax.
I find my policy to be fraudulent and the company a complete joke.
This report was posted on Ripoff Report on 09/06/2011 01:59 PM and is a permanent record located here: http://www.ripoffreport.com/r/Conseco-Health-Insurance-Company/Carmel-Indiana-46032/Conseco-Health-Insurance-Company-Refuses-to-pay-lump-sum-due-per-policy-refuses-to-give-773529. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year.
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