Report: #436660

Complaint Review: HEALTH MARKETS

  • Submitted: Mon, March 23, 2009
  • Updated: Mon, April 20, 2009
  • Reported By: York South Carolina
    YORK, South Carolina


*Author of original report: A Policy Will Pay According to the Provisions...Please Learn your Product!

*UPDATE EX-employee responds: somewhat misleading

Show customers why they should trust your business over your competitors...

I am an Independent Insurance Agent in South Carolina. I recently has an appointment with a very nice couple in York County. They knew exactly what they wanted covered on their policy, catastrophic only. I gave them the best option I had which was pricing out in the $500 range. They were both in their 50's and tobacco users. It was a true Catastrophic policy.

The customer then proceeded to pull out a quote sheet left by a Health Markets Agent. It also was around $500.00. But, it was NOT Catastrophic coverage. It clearly had a surgical expense benefit of $10,000. And a Hospital Benefit of $25,000. The Health Markets Agent was out of their Charlotte office and told the customers there was a way to save them monies. He had listed them both as NON-TOBACCO users, which dramatically lowered their rate. (I wonder if Health Market Agents know that a company will not pay a claim if the information on the application is fradulant.)

The quote was loaded with all the Companies extras...Ancillary products, such as $10,000 of Critical Care, additional Accidental coverage, as well as vision and Dental. All profit making products designed to make the Company and Agent money. But yet the Hospital would only be paid up to $25,000 per OCCURANCE..and subject to a DEDUCTIBLE PER OCCURANCE as well.

The Health Markets Agent, if effort to not reveal this to the customer, did not leave any Company Brochure.

The Health Market Agent did not reveal this coverage to the customer, who would buy a $25,000 policy per occurance for $500 a month? NO ONE!!! On top of the fact he let the customer know he was helping them as to be listed as a Non Tobacco user!

I can only hope that Health Markets does not see this as yet another RE-TRAINING opportunity! You cannot retrain Honesty and Integrity!

Here is the clincher....The customer then proceeded to tell me the Health Markets Agent was also a Minister!

York, South Carolina
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#1 Author of original report

A Policy Will Pay According to the Provisions...Please Learn your Product!

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


Maybe your should be retrained as we.. The "ALLIANCE" is nothing more than the Marketing arm of your Company. It is required on your application for a customer to APPLY for Insurance, but...It is not required for the Customer to KEEP the Insurance. They can drop your $10.00 and $40.00 association fees immediately. One has NOTHING to do with the other. As wonderful as the benefits may be..these folks are out here looking for INSURANCE...not a scam! If indeed, the so called group, to help people was so important....why would they be able to drop it immediately?

As far as the Minister, he was not presenting a PPO product. He was presenting an INDEMNITY PRODUCT! The differnce is an Indemnity product has caps and limitations, it will protect against loss ...up to certain amounts ...and then, the coverage ends. It is NOT a catastrophic plan, like a PPO that the customer clearly stated they wanted. In other words, there are holes. Many holes.

Your company agents needs to learn your product. I suggest you get a policy and read it yourself. If you are out there selling a million dollar policy, please explain why the coverage STOPS at $250,000 for transplants? Yes...STOPS!!!! And that is on your Company's PPO Plan. That in my opinion, is not helping people. There would be nothing more expensive, than a TRANSPLANT!!!! A million dollars, heck the way the plans are written with all the caps and limitations, a consumer would never..ever hit a million...because the plan would not pay. Unless of course they have 4 transplants!

A policy will pay according to the provisions...please learn yours.

Josh, I suggest you take a look at Insurance Companies...and stop hiding behind the Association. You know..the Large Group that helps people...Can't be singled out for rate increase or dropped and cancelled.

And as far as your companies pricing, they are the most expensive on the market for the least amount of coverage. That is FACT!

Try helping people and learn your product, if you would think twice about what you are presenting to folks.
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#2 UPDATE EX-employee responds

somewhat misleading

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

i don't exactly know the laws and regulations for that state, but i can clarify more some of your rant against Health Markets. after being an agent myself, i know the ins and outs, but it sounds like the agent from south carolina was crooked. now i cant sit here and bail everybody out in this company with what i have to say, but there are some inconsistencies with what you said. first off, this agent sounds like a crook who, even if he stated he was a minister, is probably a lying thief who cares about nothing other than making money. he put them down as non-smokers-wrong on his part. he gave them what seems like a PPO plan, ok. but, if they wanted pure catastrophic, they should not have gone with health markets in the first place haha. one thing that did get to me, though, was the ancillary benefit package. the package contains many great additional benefits and great ways to save money, but this isnt insurance. also, this is NOT what we make our money on. i laughed when i read that, because if i went around and just signed everybody up for the alliance and not actual insurance, i wouldn't be making a dime. the alliance is simply the large group that enables health markets to give people the affordable rates, since it's designed for self-employed, small business owners, or people not part of a large firm that already has great benefits. there's nothing wrong with health markets. if there was, we would have been out of business. the problem here is the agents. there are crooked people in every job (politics especially) and i can't stop those people from doing what they do. i would never have worked for them if they purposely screw people over. there's just shitty agents and it's sad health markets is looked down on as much as it is. from the moment i started, i knew the other agents weren't shitty. they're good people, the ones i work with at least. i had great training, and when i learned how to do the applications during the appointments, the other agent came across information that could have rated-up or even rejected the client. we notified the client of the situation, and the other agent almost stopped the app right there. and if they are rejected, they get 100% of what they submitted in terms of first month's premium and one-time application fee, no strings attached. we are picky with who we take, yes, but if the agents worked within their guidelines and didn't just try to take anybody for money, then there would be NO problem whatsoever with health markets. so please, dont get down on the company, it wont screw you. unless you have a heartless agent which is unfortunate for all of the clients who have had to go through that.
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