Complaint Review: United American Insurance Company - McKinney Texas
- United American Insurance Company .unitedamerican.com McKinney, Texas U.S.A.
- Phone: 972-529-5085
- Web:
- Category: Health Insurance
United American Insurance Company mislead me into believing my policy contained adequate hospitalization & surgical coverage McKinney Texas
*UPDATE Employee: you are sadly mis informed....from the beginning
*UPDATE Employee: you are sadly mis informed....from the beginning
*UPDATE Employee: you are sadly mis informed....from the beginning
*UPDATE Employee: you are sadly mis informed....from the beginning
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In June of 2005 I started shopping for a policy that would provide hospitalization & surgical benefits only for my husband. I was not looking to get doctor office visits covered for colds and routine examinations, because I knew no one was going to cover a pre-exsisting condition.
My husband has a seizure disorder described as Nocturnal Mio Clonis (periodically he will have a seizure in his sleep only). Nor was I looking for prescription reimbursements. I first applied to Blue Cross/Blue Shield of Florida for the Essential Care Policy. The premium for both of us would have been somewhere around $125 per mos forthe type of benefit I was looking for. The deductible was $250. They would not write the coverage because of my husbands pre-existing condition.
An agent from M & M Insurance Advisors in Sarasota FL contacted me advising of a similar plan that was guaranteed issue with a $500 deductible and cost of $197 per mos. He sent me the United American Insurance Companies Flexcare brochure (Sensible Health Insurance for Todays Lifestyles). The front indicates a Limited Benefit Basic Hospital, Medical & Surgical Expense Coverage. The "limited benefit" I construed as no doctor office visits, no prescription coverage, etc., just hospitalization and surgery coverages.
In the brochure the agent highlighted the $50,000 Hospital Expense benefit, the Surgical Expense Benefit 100% up to $7500. I though OK-this looks like a good plan. There were 2 other benefit plan amounts, $75,000 and $100,000. Each and all of the plans were based on 80% co-insurance. Of course the higher benefit plans would have increased the premium and like everyone else,
I don't want to let insurance premiums break the bank. So I take the policy which becomes effective 7/13/05. In June of 2006 my husband goes to the doctor because he has a small protrusion in his groin area. The diasgnosis is a hernia. So out-patient surgery is schedule and done. The total cost of the hospital, pre-op lab tests, anesthesia, physician who did the surgery, radiology, etc is $12,546.57 to date.
As of todays date United American has paid out $2160.02 and it doesn't look like they are going to pay anymore. So now in addition to the premiums that I have paid out over the last year ($2581) for
coverage that we thought would cover this type of circumstance, we are left with a $10,386.55 balance to the hospital.
Also, I am now aware (after the fact) that the policy is not worth the paper it is written on. This product should not be allowed to be presented to anyone. I sent a letter to the writing agent to let him know how his misreprensation will be costing us dearly and his response to me was "I never offer this plan to anyone who can get true insurance coverage, but anything is better than nothing". This I have in writing.
He also advised that he does not offer this plan anymore. I don't agree with his "anything is better than nothing" because at this point we may as well have had nothing and our premium back to go toward the balance. Even if we would have taken the $100,000 plan we still would have ended up owing somewhere around $8000. So don't let anyone try to convince you this plan is worth anything.
Beverly
Cape Coral, Florida
U.S.A.
This report was posted on Ripoff Report on 08/29/2006 04:36 PM and is a permanent record located here: https://www.ripoffreport.com/reports/united-american-insurance-company/mckinney-texas-75070/united-american-insurance-company-mislead-me-into-believing-my-policy-contained-adequate-h-208529. 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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#4 UPDATE Employee
you are sadly mis informed....from the beginning
AUTHOR: Tom - (U.S.A.)
SUBMITTED: Wednesday, September 27, 2006
Realizing that you are very upset and your experience is true, and costly...it could have been avoided.
Had the independent agent known the product well, he would have told you to be sure that your services were performed IN the hospital because the out patient non surgical benefits are limited in comparason. If your husband had had his services performed in the hospital...that's IN the hospital...not as an outpatient...you'd have had a whole lot more paid for by United American.
so your story is most likely very true..but your assumption of the policy coverage is sadly mistaken. First and foremost... the $500.00 deductable you mention... only affects the Misc. hosp. benefits...look at the brochure if you don't want to read the policy.... it is NOT based on 80% coverage... surgical benefit is FIRST DOLLAR COVERAGE.... up to the amount listed in the policy schedule listed in your policy... hence "limited policy".... there are several other things you mention that are mis-informed statements as well.
i'm not saying it's your fault...the agent did a pis-poor job of explaining your benefits and coverages...but look at the policy....there is a schedule of benefits listed in the policy...it's the first few pages....
This policy actually DOES afford adequate affordable coverage to individuals and is very effective at containing medical costs for policy holders....
I have been in the insurance field for 17 years... i've been an independent agent and now sell for United American.... proudly..and i can only wish someone would have explained to you how to use your policy effectively... it would have saved you a LOT of money.

#3 UPDATE Employee
you are sadly mis informed....from the beginning
AUTHOR: Tom - (U.S.A.)
SUBMITTED: Wednesday, September 27, 2006
Realizing that you are very upset and your experience is true, and costly...it could have been avoided.
Had the independent agent known the product well, he would have told you to be sure that your services were performed IN the hospital because the out patient non surgical benefits are limited in comparason. If your husband had had his services performed in the hospital...that's IN the hospital...not as an outpatient...you'd have had a whole lot more paid for by United American.
so your story is most likely very true..but your assumption of the policy coverage is sadly mistaken. First and foremost... the $500.00 deductable you mention... only affects the Misc. hosp. benefits...look at the brochure if you don't want to read the policy.... it is NOT based on 80% coverage... surgical benefit is FIRST DOLLAR COVERAGE.... up to the amount listed in the policy schedule listed in your policy... hence "limited policy".... there are several other things you mention that are mis-informed statements as well.
i'm not saying it's your fault...the agent did a pis-poor job of explaining your benefits and coverages...but look at the policy....there is a schedule of benefits listed in the policy...it's the first few pages....
This policy actually DOES afford adequate affordable coverage to individuals and is very effective at containing medical costs for policy holders....
I have been in the insurance field for 17 years... i've been an independent agent and now sell for United American.... proudly..and i can only wish someone would have explained to you how to use your policy effectively... it would have saved you a LOT of money.

#2 UPDATE Employee
you are sadly mis informed....from the beginning
AUTHOR: Tom - (U.S.A.)
SUBMITTED: Wednesday, September 27, 2006
Realizing that you are very upset and your experience is true, and costly...it could have been avoided.
Had the independent agent known the product well, he would have told you to be sure that your services were performed IN the hospital because the out patient non surgical benefits are limited in comparason. If your husband had had his services performed in the hospital...that's IN the hospital...not as an outpatient...you'd have had a whole lot more paid for by United American.
so your story is most likely very true..but your assumption of the policy coverage is sadly mistaken. First and foremost... the $500.00 deductable you mention... only affects the Misc. hosp. benefits...look at the brochure if you don't want to read the policy.... it is NOT based on 80% coverage... surgical benefit is FIRST DOLLAR COVERAGE.... up to the amount listed in the policy schedule listed in your policy... hence "limited policy".... there are several other things you mention that are mis-informed statements as well.
i'm not saying it's your fault...the agent did a pis-poor job of explaining your benefits and coverages...but look at the policy....there is a schedule of benefits listed in the policy...it's the first few pages....
This policy actually DOES afford adequate affordable coverage to individuals and is very effective at containing medical costs for policy holders....
I have been in the insurance field for 17 years... i've been an independent agent and now sell for United American.... proudly..and i can only wish someone would have explained to you how to use your policy effectively... it would have saved you a LOT of money.

#1 UPDATE Employee
you are sadly mis informed....from the beginning
AUTHOR: Tom - (U.S.A.)
SUBMITTED: Wednesday, September 27, 2006
Realizing that you are very upset and your experience is true, and costly...it could have been avoided.
Had the independent agent known the product well, he would have told you to be sure that your services were performed IN the hospital because the out patient non surgical benefits are limited in comparason. If your husband had had his services performed in the hospital...that's IN the hospital...not as an outpatient...you'd have had a whole lot more paid for by United American.
so your story is most likely very true..but your assumption of the policy coverage is sadly mistaken. First and foremost... the $500.00 deductable you mention... only affects the Misc. hosp. benefits...look at the brochure if you don't want to read the policy.... it is NOT based on 80% coverage... surgical benefit is FIRST DOLLAR COVERAGE.... up to the amount listed in the policy schedule listed in your policy... hence "limited policy".... there are several other things you mention that are mis-informed statements as well.
i'm not saying it's your fault...the agent did a pis-poor job of explaining your benefits and coverages...but look at the policy....there is a schedule of benefits listed in the policy...it's the first few pages....
This policy actually DOES afford adequate affordable coverage to individuals and is very effective at containing medical costs for policy holders....
I have been in the insurance field for 17 years... i've been an independent agent and now sell for United American.... proudly..and i can only wish someone would have explained to you how to use your policy effectively... it would have saved you a LOT of money.


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