Report: #427902


  • Submitted: Tue, February 24, 2009
  • Updated: Fri, October 23, 2009
  • Reported By: WILLIAMSPORT Pennsylvania
    5050 N. BROADWAY
    CHICAGO, Illinois


*UPDATE Employee: Here is what you do

* : How to get this resolved !

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I filed a claim with combined insurance on my accident policy, Dec.30th,2008 for an injury I incured after falling off a ladder while working on my house.

I'm a self-employed construction worker and bouhgt an accident policy on Sep.1998,to help with bills in case of an unexspected injury.

I injured my back Aug.20 2008. I had x-rays and an MRI done. For insurance purpuses my doctor suggested therapy,that did'nt work, which i knew it would'nt.

I then saw a Neurological surgen and had a milogram done which showed disc injury.I had surgury on Dec.8 2008 to repair the damaged disc.

I filled out the so called,simple,fast and easy claims form and faxed it to combined insurance.After a week i called them to check on the status of my claim.I was told it would take 7 to 10 working days before it would be reviewed.

Well of course it took moore than 10 days due to xmas and new years.I called them again Jan.14 1009 and they told me they needed more information from my doctor and w2ould need threr office notes.

The doctors sent this paper work and for weeks combined insurance denided receiving it.Finally after more time dragged by they received it and would need 7 to 10 days to review it.

Now it's Feb.24 2009, I called combined to check on the status of my claim.After being put on hold for 15 minutes again, i was told that my claim was denied because my doctors did'nt see me fall and how would combine know it was'nt a health problem and not an accident.

You have to be kidding me.I payed for this insurance for 10 years and in the time of need, it's not there to help pay the bills. Combine owes me two months of partial disability,four months total disability and can't go back to work till spring.

My morgage is in rears,my gas heat,electric,phone are all being threatened of termination.I can't believe this is happening. I'm in deep trouble and don't know what can do.

If there is an attorney or Government agency out there that would like to look into my situation,I would sure appriceate it.

WILLIAMSPORT, Pennsylvania
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#1 UPDATE Employee

Here is what you do

AUTHOR: Current Employee of CICA - (USA)

First off the claim can be investigated, that is legal, but I find something quirky.  On the back of the claim for where the doctor fills out his or her portion, there is a box there that they check that is either sickness or injury.  And as long as everything is supported by your documentation, then your claim should be paid.

If that does not work, each state has an insurance commisioner that is appointed by the gov. of each state.  Get them involved, its kind of protection against companies what could be considered Malpractice.

Good Luck
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How to get this resolved !

AUTHOR: anonymous - (USA)

Contact via certified mail return receipt Combined Insurance.  TELL them you will be filing a claim with the State Insurance Commission if they do not PAY on the claim withing 14 days of return receipt.  STICK TO YOUR WORD ! IF you do not have your money by 14 days file the claim.  Insurance companies are scared to be tattle-tailed on to the insurance commission.

Good Luck

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