Delta Dental of Missouri Dear Sirs: This not Attrition or the wearing down of my anterior surface of my anterior lower teeth. This was caused by fracture. A workman's compensation claim was filed years ago regarding these teeth and my upper teeth. Delta Dental approved repair of Delta Dental claims Attrition. Denied Claim The Fact is my Teeth were Fractured St Louis Missouri

Dear Sirs:

This not Attrition or the wearing down of my anterior surface of my anterior lower teeth. This was caused by fracture. A workman's compensation claim was filed years ago regarding these teeth and my upper teeth. Delta Dental approved repair of my upper teeth in the mid 1980's. I have asked the Division of workman's compensation to sent the workman's comp document to me. Also Delta dental has made untruthful statements in their final denial letter. On 11/4/2015 they indicated that my dentist did not wish to make changes to his narrative.

I asked my Dentist Dr, W*** about such and his reply to me was and I quote "That is complete B.S. I was never asked to change his statement to them". In addition Delta Dental indicated that a telephone conversation with Dr W*** on 11/19/2015 did not reveal any new information that warranted a change in either of the independent consultant reviews that had originally taken place. Once again not true as Dr. W*** explained to Delta Dental's Consultant that I had composite veneers placed on my lower teeth years ago by Dr Joseph B**** DDS. and that my teeth were prepared for the material through etching of the lower anterior teeth for preparation of my lower teeth.

Also I sent by way of Delta Dental's ************** pictures of my my lower anterior teeth and asked then to note the fracture lines which they call attrition or wear lines on my teeth as they were NOT Consistent with the arc pattern with the posterior arc of my upper anterior teeth. Also a photograph of my bite. In that photo my closed bite reveals that in fact my lower teeth do NOT touch the posterior aspect of the upper anterior teeth. Delta Dental made mention that they could not identify that these were in fact my teeth because they were posted on their face book page and that Dr. W*** my dentist did not send photos of my teeth to them which in fact is another UNTRUE statement of fact. My dentist DID in fact send the same photograph's of my teeth to Delta Dental on 11/19/2015. In addition the letter mailed to me had NO Signature affixed to their document Appeal determination 152818108, It merely was typed Appeals Committee.

The facts are clear and all of my evidence that is now being collected will show beyond a shadow of doubt, that in fact Delta Dental is merely avoiding paying this claim and their so called independent Dental advisers are actually employed by Delta Dental and like most insurance companies, they are most likey instructed to deny large dental claims if possible. The bigger question is WHY??? is Delta Dental covering number #25 and # 26 lower anterior teeth when in fact they claim my teeth are not fractured but rather this is wear caused by (attrition... wear of the lower teeth). How is it that #25 and # 26 are NOT involved in the attrition process of wear and the other adjacent are? The clear answer to me and my dentist Dr W*** DMD, is that they are denying coverage because of costs..

.I am demanding coverage on all five of the fractured teeth #23 through #27. Also be advised My dentist admitted to me that the explanation for service was sent in error as he knew I had a history of fracture.by Kerry Tebbe. on Dec. 14, 2015211 Cobblefield Court Wildwood MO. 63011314-606-6940Dear Sirs: This not Attrition or the wearing down of my anterior surface of my anterior lower teeth. This was caused by fracture. A workman's compensation claim was filed years ago regarding these teeth and my upper teeth. Delta Dental approved repair of my upper teeth in the mid 1980's. I have asked the Division of workman's compensation to sent the workman's comp document to me. Also Delta dental has made untruthful statements in their final denial letter. On 11/4/2015 they indicated that my dentist did not wish to make changes to his narrative. I asked my Dentist Dr, W*** about such and his reply to me was and I quote "That is complete B.S. I was never asked to change his statement to them". In addition Delta Dental indicated that a telephone conversation with Dr W*** on 11/19/2015 did not reveal any new information that warranted a change in either of the independent consultant reviews that had originally taken place.

Once again not true as Dr. W*** explained to Delta Dental's Consultant that I had composite veneers placed on my lower teeth years ago by Dr Joseph B**** DDS. and that my teeth were prepared for the material through etching of the lower anterior teeth for preparation of my lower teeth. Also I sent by way of Delta Dental's ************** pictures of my my lower anterior teeth and asked then to note the fracture lines which they call attrition or wear lines on my teeth as they were NOT Consistent with the arc pattern with the posterior arc of my upper anterior teeth. Also a photograph of my bite. In that photo my closed bite reveals that in fact my lower teeth do NOT touch the posterior aspect of the upper anterior teeth. Delta Dental made mention that they could not identify that these were in fact my teeth because they were posted on their face book page and that Dr. W*** my dentist did not send photos of my teeth to them which in fact is another UNTRUE statement of fact. My dentist DID in fact send the same photograph's of my teeth to Delta Dental on 11/19/2015. In addition the letter mailed to me had NO Signature affixed to their document Appeal determination 152818108, It merely was typed Appeals Committee. The facts are clear and all of my evidence that is now being collected will show beyond a shadow of doubt, that in fact Delta Dental is merely avoiding paying this claim and their so called independent Dental advisers are actually employed by Delta Dental and like most insurance companies, they are most likey instructed to deny large dental claims if possible.

The bigger question is WHY??? is Delta Dental covering number #25 and # 26 lower anterior teeth when in fact they claim my teeth are not fractured but rather this is wear caused by (attrition... wear of the lower teeth). How is it that #25 and # 26 are NOT involved in the attrition process of wear and the other adjacent are? The clear answer to me and my dentist Dr W*** DMD, is that they are denying coverage because of costs...I am demanding coverage on all five of the fractured teeth #23 through #27. Also be advised My dentist admitted to me that the explanation for service was sent in error as he knew I had a history of fracture.

This not Attrition or the wearing down of my anterior surface of my anterior lower teeth. This was caused by fracture. A workman's compensation claim was filed years ago regarding these teeth and my upper teeth. Delta Dental approved repair of my upper teeth in the mid 1980's. I have asked the Division of workman's compensation to sent the workman's comp document to me. Also Delta dental has made untruthful statements in their final denial letter.

On 11/4/2015 they indicated that my dentist did not wish to make changes to his narrative. I asked my Dentist Dr, W*** about such and his reply to me was and I quote "That is complete B.S. I was never asked to change his statement to them". In addition Delta Dental indicated that a telephone conversation with Dr W*** on 11/19/2015 did not reveal any new information that warranted a change in either of the independent consultant reviews that had originally taken place. Once again not true as Dr. W*** explained to Delta Dental's Consultant that I had composite veneers placed on my lower teeth years ago by Dr Joseph B**** DDS. and that my teeth were prepared for the material through etching of the lower anterior teeth for preparation of my lower teeth.

Also I sent by way of Delta Dental's ************** pictures of my my lower anterior teeth and asked then to note the fracture lines which they call attrition or wear lines on my teeth as they were NOT Consistent with the arc pattern with the posterior arc of my upper anterior teeth. Also a photograph of my bite. In that photo my closed bite reveals that in fact my lower teeth do NOT touch the posterior aspect of the upper anterior teeth. Delta Dental made mention that they could not identify that these were in fact my teeth because they were posted on their face book page and that Dr. W*** my dentist did not send photos of my teeth to them which in fact is another UNTRUE statement of fact. My dentist DID in fact send the same photograph's of my teeth to Delta Dental on 11/19/2015.

In addition the letter mailed to me had NO Signature affixed to their document Appeal determination 152818108, It merely was typed Appeals Committee. The facts are clear and all of my evidence that is now being collected will show beyond a shadow of doubt, that in fact Delta Dental is merely avoiding paying this claim and their so called independent Dental advisers are actually employed by Delta Dental and like most insurance companies, they are most likey instructed to deny large dental claims if possible.

The bigger question is WHY??? is Delta Dental covering number #25 and # 26 lower anterior teeth when in fact they claim my teeth are not fractured but rather this is wear caused by (attrition... wear of the lower teeth). How is it that #25 and # 26 are NOT involved in the attrition process of wear and the other adjacent are? The clear answer to me and my dentist Dr W*** DMD, is that they are denying coverage because of costs...I am demanding coverage on all five of the fractured teeth #23 through #27. Also be advised My dentist admitted to me that the explanation for service was sent in error as he knew I had a history of fracture.