- Report: #893186
Report - Rebuttal - Arbitrate
Complaint Review: Daniel Grootner
Daniel Grootner2929 South Ocean Blvd #117 Boca Raton 33432 Internet United States of America
Daniel Grootner OptumHealth Allies, The National Congress of Employers, Unified Life Insurance Company CVS Caremark. Hello my name is Abdul Vega. My wife Christine and I were solicited for family plan insurance coverage with dental and eye benefits by Daniel Gootner at America's Choice Health Group. (561)800-0700 af Internet
*Consumer Comment: I agree with you
*Consumer Comment: Same Thing Happened To Me
Daniel Grootner contacted us immediately with in seconds of my request. Daniel and I spoke over a two day period. I wrote down his description of my coverage option's and his recommendation's. Unsure of coverages provided I, asked Daniel if he could fax me a copy of the coverages and if I could start them on July 1st. He said he could not send the policy coverage breakdown without starting a plan. Daniel advised me of my right to cancel, should the coverage have been misrepresented.
Busy at work, I suggested Daniel call my wife, Christine after playing phone tag throughout the day so, he could discuss the plan with her and he did. My wife Christine asked several question's and wrote down, just as I did, notes that we later compared.
Ultimately, we chose to accept and pay for a policy as member ID #656629***;
1. No co-pay on doctor's visit(s) which according to the packet that I received, is NOT true. The Unified Life Insurance Company packet that I received states in print this coverage will cost a minimum of $50 per visit.
2. We both were told that there would be prescription coverage of 80%, with 20% to be paid by us, the policyholder. This too is not true as the packet that we received has a prescription discount card attached to it. Not actual coverage.
3. Daniel also told the both of us on two separate occasion's, that there were no maximum visits, which this too, is not true. The packet states that there is a 5 visit maximum on both accident & sickness, whether in-patient or out-patient.
4. Daniel stated that there would be no cost incurred by the policyholder(s) for emergency room visits, this too is not true as the packet states $50.00 per visit and a maximum benefit of 1 visit per coverage year.
Today, upon going over our Certificate of Coverage that we received in the mail this morning from Unified Life Insurance Company as well the "discount" cards that we received, we realized that Daniel had misrepresented OptumHealth Allies, the National Congress of Employers, CVS Caremark and The Unified Life Insurance Co.
Upon calling Daniel this morning, he had a condescending attitude from the start of our conversation. When I ask for a supervisor, he said he was a supervisor then began to attack me verbally stating that I was accusing him of lying to myself and my wife. When I tried to explain to him in a rational tone, he barked accusation's of possible illiteracy on my behalf and suggested that I was not understanding what he meant during our previous conversation's.
As our would-be conversation continued I began to realize that Daniel Gootner is as unprofessional as they come. As a Regional VP for a large retail company, I found his tone and over-talk to be disrespectful. This is not a company that anyone should be doing business with, including insurance provider's and insurance policy holder's. Daniel went on to speak about my finances ???, which had no baring on his misrepresentation of coverages, which seemed to be his way of deflecting his misrepresentation of coverages provided under the Unified National Health 200 Plan.
In addition to being unreasonably loud, rude, condescending and misleading Danial Gootner of America's Choice Health Group, dare think that his misrepresentation of coverages warranted a verbal lashing of sorts to a paying customer. I am truly not surprised after reading dozen's of complaints on ripoffreport.com, bbb.org and a other websites online.
I will be forwarding my complaint to OptumHealth Alies @ P.O. Box 10340 Glendale, CA 91209 (877)426-2559, the National Congress of Employers, the Ripoffreport.com, the BBB and Unified Life Insurance Company @ P.O. Box 25326 Overland Park, Kansas 66225.
I will also be filing a petition via facebook, to start a certified class action lawsuit against America's Choice Health Group on behalf of a large group of people as plaintiffs who have suffered some similar harm from the same actions of the defendant or defendants of America's Choice Health Group, if I do not receive a FULL refund of $276.00 which is the amount of monies that I paid to America's Health Group for the insurance coverage with a start date of June 15th which was not our agreement. See above mentioned coverage start date of July 1st pending the review of the Certificate of Coverage by myself.
Due to discrepancies found with in the Certificate of Coverage versus the 3 verbal telephone conversation's that we had, it is my conclusion that I will not require the services provided by Daniel Grootner and the companies that he will continue to misrepresent.
Thank you in advance for your assistance in this matter of immediate concern.
Abdul & Christine V
This report was posted on Ripoff Report on 06/05/2012 10:26 AM and is a permanent record located here: http://www.ripoffreport.com/r/Daniel-Grootner/internet/Daniel-Grootner-OptumHealth-Allies-The-National-Congress-of-Employers-Unified-Life-Insur-893186. 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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