• Report: #334840
Complaint Review:


  • Submitted: Mon, May 26, 2008
  • Updated: Fri, May 18, 2012

  • Reported By:STMARYS Georgia


*Consumer Comment: I agree with Nikki's comments - and would like to amend some information

*Consumer Suggestion: Did you appeal in writing?

*Author of original report: UNITED HEALTH CARE, ATLANTA,GEORGIA Report to BBB & Attorney General

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On 2/2008, I went to the Emergency,and later admitted in the hospital, went through a number of test and also specialist were called upon to help diagnois my sudden illness. At any rate every other week from my payroll they have know problem collecting money for insurance that I needed.

After I was discharged, Went home and thought that all of my exspenses would be taken care of because they are my primary insurance and I do have a secondary, well I got my hospital bill total; 13,000.00 and United Health Care only paid 23.23 and they had the nerve to apply it to my deductable. They claim that I had a preexisting condition but it was'nt because I had not seen a doctor for the entire year of 2007. For every piece of info that they needed me to foward to them regarding my health and other insurance, I have furnished it.

To this date they have not paid another penny on my claim, but, they are still happily taking my money through payroll deduction. I have spent everyday that I have been on sick leave trying to resolve this situation,with fruitless results.... BEWARE --- BEWARD. JP St Marys,GA

STMARYS, Georgia

This report was posted on Ripoff Report on 05/26/2008 03:57 AM and is a permanent record located here: http://www.ripoffreport.com/reports/united-healthcare-uhc/nationwide/united-healthcare-united-healthcare-uhc-they-find-every-fault-that-they-can-possibly-thin-334840. 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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Updates & Rebuttals

#1 Consumer Comment

I agree with Nikki's comments - and would like to amend some information

AUTHOR: smart consumer - (United States of America)

I'm so sorry you had a negative experience regarding United Healthcare - and I hope you're feeling much better now.  Nikki gave you excellent advise and I hope that it helped you out regarding your claim. 

I would like to give some additional information, since I work & have worked with insurance-related stuff (even though it's over 4 years since you filed your report, but may be also helpful for other consumers).  Nikki mentioned a Georgia law that prohibits a preexisting condition clause taking effect if you had a lapse in coverage less than 60 days.  What she is probably referring to is HIPAA, which is a Federal law covering all 50 states.  HIPAA says that if there is a break in coverage of 63 days or less, preexisting condition exclusions are prohibited IF you have had continous coverage with a group health plan for 18 months or more.  If you have had that kind of coverage for 18 months or more, when you leave a plan, your former carrier is required to provide you with a certificate of group health coverage.    They are actually also required to provide this even if you have had less than 18 months since each month you have had coverage will reduce the number of months of a preexisting condition exclusion.  You would then provide this certificate information to your new carrier.

I hope this helps!
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#2 Consumer Suggestion

Did you appeal in writing?

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

I hope you appealed, in writing, using their appeal form (I believe it can be found online). If you haven't, do so immediately. You only have a certain amount of time to appeal and it may be 90 days (hopefully for you it's 180 days).

Also, how long have to had the insurance for? Even pre-existing conditions under group policies are supposed to be covered after 12 months of continuous coverage (unless they changed that clause within the last few years).

Also, if you had coverage through another insurance company up to within 60 days of the start of your United Healthcare coverage, they are supposed to cover pre-existing conditions from day 1 of your coverage (I'm not sure if this is only a Florida law).

Go onto the Georgia bureau of insurance regulation website and read their laws for insurance companies licensed in your state regarding group health insurance and pre-existing conditions. Do not let the insurance company just tell you, because they will probably give you the wrong info.

I'm not in the insurance business, I just had these ideas to throw around for you to find out more.
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#3 Author of original report


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

I decided on this date also to this date to report this Insurance company UNITED HEALTH CARE, ATLANTA GEORGIA to the BBB and to the Attorney General so that know one else will be Ripped Off, and especially older person like myself...
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