• Report: #54167

Complaint Review: Mid-West National Life Insurance Of Tennessee

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  • Submitted: Wed, April 23, 2003
  • Updated: Wed, January 24, 2007

  • Reported By:Rolling Meadows Illinois
Mid-West National Life Insurance Of Tennessee
9151 Grapevine HWY North Richland Hills, Texas U.S.A.

Mid-West National Life Insurance Of Tennessee Refuses to pay hospital bills. My hospital, doctors or I have receive no payments. My credit has been ruined. North Richland Hills Texas

*Consumer Comment: Sounds like I dodged a lemon MIDWEST NATIONAL LIFE.

*Consumer Comment: stupid people

*Consumer Comment: Forced Coverage

*UPDATE EX-employee responds: Caveat Emptor - Still A Sound Legal Principle

*Consumer Comment: Non biased remark.

*Consumer Comment: Non biased remark.

*Consumer Comment: Non biased remark.

*Consumer Comment: Non biased remark.

*Consumer Comment: Wow Michael... You aren't the sharpest tool in the shed, are you...

*UPDATE Employee: Something is up

*Consumer Suggestion: read contract or not.........bad insurance

*Consumer Comment: SOON-TO-BE-FORMER MWTL POLICY HOLDER

*Consumer Comment: WHY was the claim denied?

*Consumer Comment: Why blame the consumer

*Consumer Comment: Why blame the consumer

*Consumer Comment: Why blame the consumer

*UPDATE Employee: Read your contract before you assume what you have

*Consumer Suggestion: Mid-West ..This is another example of someone not READING the CONTRACT.

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My daughter and I thought we had medical coverage though this compay, but it appears that we only pay for insurance. When medical bills are presented they are denied for payment. The list of excuses is long for this company. 80% coverage of medical bills must have only been a promise by Mid-West Life Insurance Company. It is certainly not a promise they intended on keeping.

My doctor called Mid-West Life Insurance to make sure the procedure was covered. Mid-West said it was covered and then they refused to pay my doctor. My credit and my relationship with my doctors has changed.

Raffaella
Rolling Meadows, Illinois
U.S.A.

This report was posted on Ripoff Report on 04/23/2003 05:28 PM and is a permanent record located here: http://www.ripoffreport.com/r/Mid-West-National-Life-Insurance-Of-Tennessee/North-Richland-Hills-Texas-76180/Mid-West-National-Life-Insurance-Of-Tennessee-Refuses-to-pay-hospital-bills-My-hospital-54167. 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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0Author 18Consumer 0Employee/Owner
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#1 Consumer Comment

Sounds like I dodged a lemon MIDWEST NATIONAL LIFE.

AUTHOR: Carmen - (U.S.A.)

NO ONE LIKES TO BUY INSURANCE It's just one of life's little EVILS!

I have been looking for additional health insurance coverage to compliment my current policy. I had been speaking with a Division Sales Leader' representing MIDWEST NATIONAL LIFE aka: Alliance for Affordable Services aka: Cornerstone America.

Unlike a comment in an earlier rebuttal I spend quite a bit more time on picking my insurance than a TV. I had a few questions before I made my final decision. He (#1 Sales Leader) had been persistent and timely w/his callback and I thought that to be a good quality.

After the initial greeting of hello he followed it with some colorful S#@%, with the last @#^& followed by I made $360, 000 last year. Excuse me. He repeated his income once again.
The small curse words didn't really bother me but I wondered how him calling me re insurance turned to his GROSS EARNINGS. He proceeded to tell me he was the NUMBER ONE sales leader in California with 15 sales persons under him. I asked how much of that was repeat customers, I got the feeling happy repeat client were not his concern.

Now I wanted to see how far he would go before he was on the verge of making every mistake possible in professional sales. I asked him one question re: my potential health insurance policy: What % of my Dr. visit wd my co-pay be?
#1 sales leader DIDN'T KNOW!!!!

This NUMBER ONE DIVISION SALES LEADER did not know the answer. Waiting from him to respond with an answer to my question
I heard him talking with someone doing calculations and not on my policy.
That's when I hung up!

He called back within the hour to apologize and to ask if I was ready to sign. SIGN? I don't think so.
His response was WELL I AM JUST NOT GOING TO HELP YOU! And he hung up on me.
THANK GOODNESS that is probably the best customer service he could have gave me.

That is when I did another search and found your web site with all the unhappy consumers with MIDWEST NATIONAL LIFE.

And for those of you that made statements like read your contract.
Your Agent/ Broker #1 sales leader should explain clearly and be there to assist you if an issue arises.
One consumer to another Thanks I am not buying what you're selling
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#2 Consumer Comment

stupid people

AUTHOR: Odysseus - (U.S.A.)

This is to all the smug smart aleck individuals that think that those of us who have had a problem with mid-west did not read the fine print.

In my case back in 2001, It took 1 yr and having the florida ins. commissionors involvement in getting our claim settled. Mid-west gave us the run-around with the usual "we did not, or send us, or the doctor did not, or I did not" etc. They even give the Ins. Commissioner the same line of crap, but under the auspicious of the Commissioner Mid-west payed up. So, to all you self rightious Idiots who think that the complaints have no merit, Why was I named in a classaction lawsuit 1 yr later? 2002-2003 to be exact? The complaints are not isolated or without merit. Those of you who have a rebuttle against those of us who have had negitive experiences with mid-west either are company hacks or bloggers that have no life and need a serious dose of reality.
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#3 Consumer Comment

Forced Coverage

AUTHOR: Elizabeth - (U.S.A.)

While I agree that you should look before you leap, coverage from this company was forced upon me by the public school system. My child is a student athlete and I was forced to buy coverage from a company that I had never hard of. I knew they would be a secondary provider but i never recieved anything from them telling me what they would or wouldn't cover. My daughter sustained severe injury during a track meet and even now 6 months after my childs injury I am having a very difficult time to get thm to pay even a small portion of the doctors visits. I don't mind paying my $20 copay every time but between 2 insurance poicies I should not be paying the bulk of the bills!
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#4 UPDATE EX-employee responds

Caveat Emptor - Still A Sound Legal Principle

AUTHOR: John - (U.S.A.)

This company, its contracts, and as near as I can tell, its people are exactly what they say they are, no more and no less.

With all due respect, there is no evidence presented here whatsoever that any wrong was done by any party to this particular contract other than the insured!

1. No one, especially no voice on the phone, has any legal authority to 'authorize' what is already stated in the contract.

2. Neither the doctor calling the insurance company, nor what the individual at MWNL allegedly said is relevant.

The specific coverages, limitations, and exclusions of the contract are expressly stated in the contract itself.

So, even if the person on the phone referenced the wrong contract when speaking to the doctor and mistakenly said that a procedure or treatment would be payable, that statement on the phone does not supercede the written provisions of the contract.

3. In any case, calling the insurance company is no guarantee of payment to the physician, especially if the insured failed to disclose a pre-existing condition or other material fact on the application that would cause a claim to be denied that otherwise would be paid. Furthermore, any doctor in private practice already knows this.

So, the argument that the doctor was calling to ensure payment is not valid.

Too many people fail to act in their own best interest for too many reasons. This individual alone bears responsibility for this situation. The contract speaks for itself. The consumer is responsible himself/herself alone to understand the coverages, exclusions, and limitations described in plain language in the insurance certificate and in the promotional material.

People will take a health insurance contract with very little coverage when it counts -just because the monthly premium and the deductibles, etc. are low. Heck, some HMOs are 'FREE' - that is, until you actually have to USE them!
I hear it all the time.

"I never go to the doctor." "I'm perfectly healthy, my family all lived past the century mark." "I never get sick." These are just a few of the justifications people use for settling for 'cheap' coverage. But their reasoning is overturned the second they get hit by a drunk driver, get cancer, or some other life-threatening condition that tallys up hundreds of thousands of dollars for a SINGLE hospitalization. Then suddenly it becomes the agent's / company's / contract's fault that they are woefully underinsured.

What I tell people is this:
When shopping for health insurance, the most important thing to compare between policies and providers is anything and everything that is NOT covered!

Look closely and carefully at ALL exclusions and limitations!! Here is where you will find what WILL come out of your pocket, and what WILL cause you to jeopardize your investments, your home equity, everything you've worked all your life for - if you are underinsured when the unexpected occurs.

EXPECT TO PAY for your protection! Anyone that says they can get you 'full coverage' for 'cheap' can show you low premiums, zero deductibles, you name it! BUT, be sure that your definition of 'full coverage' is the same as the agent, the company, and most importantly the contract itself.

Yes, I worked briefly as an agent, and sold the health, life and annuity contracts underwritten by Midwest National Life of TN. I decided to leave when I realized I wanted more than a captive relationship with a single entity with a limited niche market. Their products are perfectly fine for what they are, and for the market they serve.

Their best coverage during my tenure was as good or better than anything out there, and it was EXPENSIVE [as any truly good coverage is]. But, interestingly, I almost never sold the best they had, even though my prospects in most cases could very well afford the premium! I would offer it, but they would invariably settle for 'better than nothing' coverage that was inexpensive, rather than commit to their own financial peace of mind.
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#5 Consumer Comment

Non biased remark.

AUTHOR: Alexander - (U.S.A.)

I also am an insurance agent. I won't say for which company, but it is the customers responsibility to find out more information about the company, their policy and its payment schedule. Only the customer knows their own situation, it is impossible for the agent to know what is best for the customer without meeting with them personally answering questions and getting asked questions.

Personally I provide all the information to my customer when I make an appointment with them, in person, to go through the coverage and any concerns that they might have. Even once they have their policy I encourage them to call me again to come to their home, or wherever, and review their policy with them. I also encourage them to do research on each company that they are considering and to call me please if they have any questions. Many times people see one bad thing like this form and are putt off forever, when there is always a reasonable explanation for it. If you believe you have been wronged then you have every right to contest the charges and take whichever company to court.


Yes, there are agents that will not return your calls, but you are able to go directly to the company itslef to get your answers, they will have you on file. Many times the agents are not avoiding you though, they might have left the company and are no longer a licensed agent with the company. I appologize for the bad agents in my company, but there are bad agents in any company that you may go to. It is just bad luck if you get a bad one, however you can request help from a higer source.

Above all, make sure you know what kind of coverage you are getting, do your homework. The lowest price is USUALLY the lowest price for a reason. Find out why before you jump right in to a policy that covers nothing. Sometimes the lowest price does have legitimate coverage, make sure you have a trustworthy and knowledgable agent explain everything to you and compare policies.

Finally, if you are not a licensed insurance agent, or have not had a problem with the company. I don't think that you have the right or adequate knowledge to post any forms on this page and slander agents with good intentions who are making their living, sometimes measly and frustrating, keeping people from medical financial burdens.
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#6 Consumer Comment

Non biased remark.

AUTHOR: Alexander - (U.S.A.)

I also am an insurance agent. I won't say for which company, but it is the customers responsibility to find out more information about the company, their policy and its payment schedule. Only the customer knows their own situation, it is impossible for the agent to know what is best for the customer without meeting with them personally answering questions and getting asked questions.

Personally I provide all the information to my customer when I make an appointment with them, in person, to go through the coverage and any concerns that they might have. Even once they have their policy I encourage them to call me again to come to their home, or wherever, and review their policy with them. I also encourage them to do research on each company that they are considering and to call me please if they have any questions. Many times people see one bad thing like this form and are putt off forever, when there is always a reasonable explanation for it. If you believe you have been wronged then you have every right to contest the charges and take whichever company to court.


Yes, there are agents that will not return your calls, but you are able to go directly to the company itslef to get your answers, they will have you on file. Many times the agents are not avoiding you though, they might have left the company and are no longer a licensed agent with the company. I appologize for the bad agents in my company, but there are bad agents in any company that you may go to. It is just bad luck if you get a bad one, however you can request help from a higer source.

Above all, make sure you know what kind of coverage you are getting, do your homework. The lowest price is USUALLY the lowest price for a reason. Find out why before you jump right in to a policy that covers nothing. Sometimes the lowest price does have legitimate coverage, make sure you have a trustworthy and knowledgable agent explain everything to you and compare policies.

Finally, if you are not a licensed insurance agent, or have not had a problem with the company. I don't think that you have the right or adequate knowledge to post any forms on this page and slander agents with good intentions who are making their living, sometimes measly and frustrating, keeping people from medical financial burdens.
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#7 Consumer Comment

Non biased remark.

AUTHOR: Alexander - (U.S.A.)

I also am an insurance agent. I won't say for which company, but it is the customers responsibility to find out more information about the company, their policy and its payment schedule. Only the customer knows their own situation, it is impossible for the agent to know what is best for the customer without meeting with them personally answering questions and getting asked questions.

Personally I provide all the information to my customer when I make an appointment with them, in person, to go through the coverage and any concerns that they might have. Even once they have their policy I encourage them to call me again to come to their home, or wherever, and review their policy with them. I also encourage them to do research on each company that they are considering and to call me please if they have any questions. Many times people see one bad thing like this form and are putt off forever, when there is always a reasonable explanation for it. If you believe you have been wronged then you have every right to contest the charges and take whichever company to court.


Yes, there are agents that will not return your calls, but you are able to go directly to the company itslef to get your answers, they will have you on file. Many times the agents are not avoiding you though, they might have left the company and are no longer a licensed agent with the company. I appologize for the bad agents in my company, but there are bad agents in any company that you may go to. It is just bad luck if you get a bad one, however you can request help from a higer source.

Above all, make sure you know what kind of coverage you are getting, do your homework. The lowest price is USUALLY the lowest price for a reason. Find out why before you jump right in to a policy that covers nothing. Sometimes the lowest price does have legitimate coverage, make sure you have a trustworthy and knowledgable agent explain everything to you and compare policies.

Finally, if you are not a licensed insurance agent, or have not had a problem with the company. I don't think that you have the right or adequate knowledge to post any forms on this page and slander agents with good intentions who are making their living, sometimes measly and frustrating, keeping people from medical financial burdens.
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#8 Consumer Comment

Non biased remark.

AUTHOR: Alexander - (U.S.A.)

I also am an insurance agent. I won't say for which company, but it is the customers responsibility to find out more information about the company, their policy and its payment schedule. Only the customer knows their own situation, it is impossible for the agent to know what is best for the customer without meeting with them personally answering questions and getting asked questions.

Personally I provide all the information to my customer when I make an appointment with them, in person, to go through the coverage and any concerns that they might have. Even once they have their policy I encourage them to call me again to come to their home, or wherever, and review their policy with them. I also encourage them to do research on each company that they are considering and to call me please if they have any questions. Many times people see one bad thing like this form and are putt off forever, when there is always a reasonable explanation for it. If you believe you have been wronged then you have every right to contest the charges and take whichever company to court.


Yes, there are agents that will not return your calls, but you are able to go directly to the company itslef to get your answers, they will have you on file. Many times the agents are not avoiding you though, they might have left the company and are no longer a licensed agent with the company. I appologize for the bad agents in my company, but there are bad agents in any company that you may go to. It is just bad luck if you get a bad one, however you can request help from a higer source.

Above all, make sure you know what kind of coverage you are getting, do your homework. The lowest price is USUALLY the lowest price for a reason. Find out why before you jump right in to a policy that covers nothing. Sometimes the lowest price does have legitimate coverage, make sure you have a trustworthy and knowledgable agent explain everything to you and compare policies.

Finally, if you are not a licensed insurance agent, or have not had a problem with the company. I don't think that you have the right or adequate knowledge to post any forms on this page and slander agents with good intentions who are making their living, sometimes measly and frustrating, keeping people from medical financial burdens.
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#9 Consumer Comment

Wow Michael... You aren't the sharpest tool in the shed, are you...

AUTHOR: Dave - (U.S.A.)

The reason a doctor's office calls an insurance company is to make sure the surgery IS covered and they will get their money. What planet are you from?
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#10 UPDATE Employee

Something is up

AUTHOR: Michael - (U.S.A.)

Something is not right with this post. I have worked for Mid-West National for over 4 years now. I have only had "1", that's right "one" claim ever get denied in over 2 million dollars worth of insurance issued. It was due to the Doctor misfiling it. After it was refiled it was resolved.

However Mid-West National does not require PRECERTIFICATIONS! So why were they contacted, and who did they call? There isn't a department for precertifications! The plan is set up so that there is no "resonable and customary" clauses or "medically necessary" problems. The doctor determines what is necessary. The only reason that the claim could be denied is that it was a pre-exhisting condition that had been excluded, or had not gone through the waiting period. Or if it was a optional cosmetic proceedure, then it would not be covered. The plan is set up to pay EXACTLY how it is written with no loop holes for the consumer to get caught up in.

And then to say that the agents are sub par? We have to go through the same licensing that every other agent in the country does. In fact our company invests a lot of money and time to make sure that we are at the top of our game. EVERY YEAR we have to go back and take tests on the products we sell in EACH state that we are licensed to sell in. Most state insurance boards don't require that to keep your license.

And yes some agents do not have thier home phones listed. There is nothing wrong with that. I use my office and my personal cell phone. My clients have both. I have a family, and when I am with them I do not want to be disturbed. Yes I still answer it on weekends as long as I am not in family time, but I do frequently check the messages. If something is important I call back immediately. In fact some of my clients are stunned when I pick up at 10pm or on a Saturday/Sunday. Does your mechanic give you his home number? Do the people you do business with have yours? When I am running appointments during the week, my cell is the only way you will get in touch with me. Do you want a phone I can answer, or a message box that I may get to in a few days?

The bottom line is that something is not right with this. The policies are written, and then mailed to the holder. What she did with that afterwards is anyones guess. We don't even know what kind of claim it was, or how soon it was filed. Did she buy insurance to pay for a surgury that was already scheduled? We may never know, but we do know that she had a copy of her plan in hand. All she has to do is open it up, and see where it is covered. Once she has that, there is no way that the policy could not pay out.
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#11 Consumer Suggestion

read contract or not.........bad insurance

AUTHOR: Gordon - (U.S.A.)

Mid West is the same company and plan design as Mega Life.....known as National Assoc of Self Emp. Sorry plans.

When a doctor's office is calling to "verify benefits" they are just giving them a scope of intended care and getting the green light for the proceedure. The doc's office and a policy holder will allways be told that pre-cert and verification of benefits does not constitute a "guarantee of claims payments" all policy limits and provisions will allways apply. It could have been a pre-x or any other limit. Both companies and the plans they sell are dangerous to consumers.

It is the consumers responsibility to READ the plan right away when issued. If you can't get answers to question right away it should be a good signal that something is wrong. All of my clients have my home and cell numbers and I go over each plan when delivered. I have them initial any areas that point out limits or exclusions.

I never tell a client to cancel a current plan, but to stop paying the premium when I notify them that they are issued with the new carrier. That way they are still in the 30 day grace period while they look over the new plan and make a permanent decision to keep it or drop it and start paying premium on the original plan.

You will very rarely get an agent from either of these companies to call you back. They are used to having thier buts chewed so many times that most don't even give thier home number out, but have a voice mail accout set up and they have thier home phones unlisted.

Most of the agents that go to work for them are neophites......no experience and they believe the bologna that is taught to them.

Beware....be careful......and read...please.
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#12 Consumer Comment

SOON-TO-BE-FORMER MWTL POLICY HOLDER

AUTHOR: Brea - (U.S.A.)

First of all, I would like to point out that each of these rebuttals implies that they did not read the original complaint thoroughly. The patient did not call the insurance company to confirm coverage, her PHYSICIAN called them. Many companies refer physician calls to a different slate of service reps than those who handle policy holder calls. It is a reasonable assumption that the physician's conversation with the rep was informed, clear and concise. Also, the rebuttals seem to believe that the patient submitted a claim to the company for payment but, as I read it, the doctor's office submitted the claim and if it were coded incorrectly the physician's staff would have checked this when coverage was refused.

Second, I will soon be cancelling my policy with MWTL because of total lack of service from my agent. I made half a dozen contacts with three critical questions about my policy coverage. She neither returned phone calls nor replied to emails. I have been paying premiums monthly yet am paying out-of-pocket for everything I am supposed to be covered for. The agent's business conduct reflects back on the company, so the entire company is losing my business, not just this agent.

Lastly, I have read my contract with MWTL and I assure you, only a lawyer would consider that 'plain English'.
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#13 Consumer Comment

WHY was the claim denied?

AUTHOR: Layne - (U.S.A.)

There are so many reasons why a claim can be denied. You don't really say why, just "they refused to pay my doctor". Was there an accident/injury report to fill out? A pre-existing condition? Annual update forms? Was the procedure medically necessary?
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#14 Consumer Comment

Why blame the consumer

AUTHOR: Chanda - (U.S.A.)

In the original complaint, the insured party said that she called Mid-West national Life and was told by one of their supposed knowledgeable representatives that the procedure should be covered under her medical plan. Why is she considered to be at fault for receiveing misleading information. She is not to blame for what she is told by her insurance carrier. That doesn;t make her less intelligent and to question her ability to read is insulting.Her carrier gave her shitty service and a shitty promise. That's not her fault. She should seek further assistance with this matter.
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#15 Consumer Comment

Why blame the consumer

AUTHOR: Chanda - (U.S.A.)

In the original complaint, the insured party said that she called Mid-West national Life and was told by one of their supposed knowledgeable representatives that the procedure should be covered under her medical plan. Why is she considered to be at fault for receiveing misleading information. She is not to blame for what she is told by her insurance carrier. That doesn;t make her less intelligent and to question her ability to read is insulting.Her carrier gave her shitty service and a shitty promise. That's not her fault. She should seek further assistance with this matter.
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#16 Consumer Comment

Why blame the consumer

AUTHOR: Chanda - (U.S.A.)

In the original complaint, the insured party said that she called Mid-West national Life and was told by one of their supposed knowledgeable representatives that the procedure should be covered under her medical plan. Why is she considered to be at fault for receiveing misleading information. She is not to blame for what she is told by her insurance carrier. That doesn;t make her less intelligent and to question her ability to read is insulting.Her carrier gave her shitty service and a shitty promise. That's not her fault. She should seek further assistance with this matter.
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#17 UPDATE Employee

Read your contract before you assume what you have

AUTHOR: Michael - (U.S.A.)

This is a case of someone not doing the proper thing before it became to late. Insurance companies are regulated and have to abide by what they write in the contract. If a person who applys for a policy weather it is with Mid-West National Life of Tennessee or any insurance company they recieve a contract once being accepted. If that individual is to lazy to read the contract so they can understand how the plan works and what it covers and doesn't cover than it is their own fault. Of course the natural reaction to a claim not being paid is to freak out and blame everyone but themselves. It is this person fault for not reading the contract. Also I can bet money that when this indvidual said the company told her the procedure is covered never got the name of that person who said it was covered. Also the other possiability in this case could have been the fault of the insurace coder who works at the doctor's office who maybe have coded the procedure incorrectly. This is a very common mistake. If it was coded incorrectly then yes the insurance company wouldn't pay for it if it is not covered. Did this client call to make sure they coded correctly? Probably not. So again whos fault is it? I say the client for not reading and understanding her contract.
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#18 Consumer Suggestion

Mid-West ..This is another example of someone not READING the CONTRACT.

AUTHOR: Jay - (U.S.A.)

The sad truth is most people want to THINK the health care policy will cover EVERYTHING so they don't read it until it is too late. Then they complain that things aren't "as they SHOULD be".

There is no excuse for not reading your contract. It is written is plain english and is easy to read. It spells out exactly what the insurance company will pay for. The insurance company will always pay exactly what it says it will pay for. It will NOT pay for something just because you think it SHOULD pay for a procedure or visit.

Am I an insurance company? Nope! I am just the opposite - a consumer advocate against companies. But if a consumer acts foolishly just because they have an unreasonable "dream" of the way things should be, there is nothing I can help them with.

You CAN shop for health care insurance and get good coverage. But it takes WORK. Most people spend more time shopping for TV's than for health care insurance. Which is more important?
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