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Report: #177365

Complaint Review: Mega LIfe & Health Insurance Company - Sue Moon - Oklahoma City Oklahoma

  • Submitted:
  • Updated:
  • Reported By: Dayton Ohio
  • Mega LIfe & Health Insurance Company - Sue Moon North Richland Hills Texas 761828010 Oklahoma City, Oklahoma U.S.A.

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To whom it may concern:

My name is Danny ****. My wife & I retired to start our own business April 8, 2005. We had COBRA through my employment but decided to find something cheaper for both of us since it would only cover us 18 months which would have been till october, 06.

My wife searched the net and was contacted by Sue Moon from Mega Life. she came to the house and we told her we were looking for major medical cheaper than COBRA would be. My wife ask if there would be any problems with pre-existing conditions because at that time I was a diabetic not on insulin controlled by diet and medication. She stated that would be no problem and this is the best we could get. We paid our premiums faithfully every month of $471.95 the first one little more $595 something which my wife has a record of.

On November 4, 2005 I had a heart attack. When the hospital filed the claim to pay for my coronary intensive care stay 4 days they said I had no ins but my wife was fully covered. At this time I was confused because I was led to believe when Ms. Moon left my home my wife and I both had major medical which is what she led us to believe.

Come to find out she sold me accident only which makes no sense if you think about it because why would I even purchase an accident only policy when I needed major medical for my wife and I both. My wife and I both cancelled our policies because she had to pay for her mamogram out of pocket so you tell me how they can tell me she is fully covered when this is preventive medicine?

I have written Mega Life with copies to their president and to the president of the national association for the self employed, to the better business bureau and to the attorney general and the Ohio ins. commission. The only thing they come up with is we had 10 days to review the policy to make sure this is what we wanted and since we didn't it is more or less our problem. However, I totally disagree because I didn't see any reason to review it because I thought my wife and I were fully covered.

Miss Moon represnted me and she knew when she left my home what she sold to us so to take unfair advantage to sell something just to get a commission is not right. What I would like them to be forced to do is pay off my hospital bill, and my heart doctor bill since he saved my life and pay back all the money I spent for my premiums I paid for services I didn't get.

Enough class action lawsuits against them should put them out of business and since they are in the insurance business to help people they should be put out of business for misrepresentation and unfair practices.

If you need to contact me you may do so at 9phone number deleted - see below) or by email at (email deleted - see below). I thank you for any assistance in the matter to clear this up as soon as possible.

Sincerely,

Danny
Dayton, Ohio
U.S.A.

CLICK here to see why Rip-off Report, as a matter of policy, deleted either a phone number, link or e-mail address from this Report.

This report was posted on Ripoff Report on 02/21/2006 04:01 PM and is a permanent record located here: https://www.ripoffreport.com/reports/mega-life-health-insurance-company-sue-moon/oklahoma-city-oklahoma-76182-8010/mega-life-health-insurance-company-sue-moon-ripoff-oklahoma-city-oklahoma-177365. 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. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content

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REBUTTALS & REPLIES:
0Author
2Consumer
0Employee/Owner

#2 UPDATE EX-employee responds

Just to set the record straight

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

POSTED: Friday, March 17, 2006
I'm an ex-agent for MEGA and I just wanted to set the record straight. Now, first let me say that the plans MEGA sells are limited and I can understand how the general public could be confused about their plans. One of the major reasons I quit was that I couldn't sell the products offered and feel good about it. However, it's not because I would lie about what I was selling -- or that MEGA told me to lie about what I was selling. I just knew that these plans weren't the best available product to the consumer.

Let me say that MEGA does not ever call any of their plans MAJOR MEDICAL. They stress this in training and continue to stress this in weekly sales meetings. The plans of MEGA are plans designed basically for people desiring catastrophic or basic hospitalization coverage. You can add on additional benefits by buying additional riders.

Danny, I empathize with your plight, but when you say "I didn't see any reason to review it because I thought my wife and I were fully covered", well that is simply maddening to me. People of America, YOU are responsible for your own well being. Not the government, not your neighbor, but YOU. Read what you sign. You already know that insurance is expensive and complicated, so when you sign up for a plan with a reduced rate, and knowing that you already had questions about your own pre-existing conditions, how could you NOT read the policy. The 10 day free look is a law designed to help you in this exact situation. I cannot speak to what your agent told you or did not tell you, but again, I can emphatically say that MEGA does tell its agents to fully disclose and explain their plans. Now I will say that I know the particular agent you reference is currently 2nd nationwide in sales for the year for MEGA, perhaps less than ethical sales are the reason. I do not know. But please accept responsibility for your own faults as well.

In response to the fact that MEGA pays its agents just to turn in apps, I think it needs to be explained that yes, agents receive advances within a week of application submittal. However, if the application comes back as rejected or the policy is dropped, then the agent must pay this money back to the company. Such situations were disapproved by the company, and if an agents no takes or policy drops got too high, the company would take action against the agent.
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#1 UPDATE EX-employee responds

They get paid just by turing in applications

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

POSTED: Wednesday, March 01, 2006
It's correct that you have 10 days to review your policy before you accept it. That's probably why the department of insurance won't do anything and also probably why Mega Life won't do anything.

Everyone should know that Mega Life pays their agents just for turning in applications. Most insurance companies only pay agents after the application is approved and accepted. But Mega pays an immediate advance to that agent just days after an application is submitted. That creates a breeding ground for agents who might be behind on bills to simply submit as many applications as they can.

If your situation that agent clearly knew that Mega does not accept diabetics. At at point she'd either have to leave the appointment with no check or sell you a non-underwritten product - like an accident only policy in order for her to check a check.

You might not have a remedy from the department of insurance but I'd look into hiring an attorney and sueing the agent directly.
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