United American Insurance Company United American Insurance Company and agent outright lied, misrepresented policy and surgical coverage, takes advantage of self-employed by selling fraudulent, useless policy. McKinney Texas

elizabeth, i am glad i found your report on your medical bills. i am a agent, and when i find someone with united american i go after that insurance company with all the info i can muster to get them out of the united american major medical policy that the agent told them it was! and yes agents really do tell people that its an 80/20 plan 500 deductable it will pay all your hospital bills. well elizabeth we know this is not true, but a lie just to get the sale. and for the saying people cant afford a major medical that this insurance is a good product.

i replace united american policys with a 5 million dollar MAJOR MEDICAL policy for less money than they are paying for the united american policy. now some advise to anyone looking for insurance, first call the hospital billing department ask how that insurance company pays there claims. check your state department of insurance consumer complaint ratio. (united american has an extremly high complaint ratio). im going to print your story elizabeth. hope your story helps someong in the furture to get them out of the UA policy and into a major med.

You have some nerves to insult someone who is troubled with medical bills and just found out that, oooppss, it wasn't the right coverage! Why wasn't it?

Could it be that the agent who made her sign maybe was a little too fast and pushy, and not to concerned in making her understand that she was actually not covered for certain medical procedures? Could it also be that since she had a medical condition maybe she just wanted to get any coverage ASAP and just get it over with?? I mean, afterall shouldn't all these insurances be close enough the same?

Yeah she should have read the little bitty tiny fine prints (which by the way require the presence of a lawyer just to understand the legal meaning of all that burocratic language) in the 1000 papers she had to sign, but guess what Amy?

She actually trusted the agent, which had coffee in her house, and made it sound like the deal of a lifetime, knowing very well that she was omitting essential passages that need to be known, but of course it's our responsibility to read that right Amy?

I personally had issues with my PPR insurance which sometimes decides not to pay my claims for whatever reason, and after I send them official warning letters magicly they pay the claim they owe! It happens every day!

But let's assume this unfortunate woman didn't read the fine prints like you accuse her, wouldn't you say that an agent who comes to your home to explain the policy details should be 100% clear on every aspect of the policy, and receive positive feedback before making someone sign? Or maybe she was more interested in her quick commission, just like any unscrupulous car dealer who sell you any lemon pretending it's a great car?

Bottom line Amy, as much as you think you are a smart fine print reader, what happened to her could easily happen to you, because insurance companies are profit organizations, don't you ever forget that!

Wow.

I really despise whiners. Even more so when bearing a false report against someone - even a company. So I take the time to check out what people say, like you.

You buy a health insurance policy but don't take the time to READ it, understand it, or validate it's features before the Free Look Period expires, then when it doesn't live up to your expectations. it's of course, someone else's fault. Do you buy car insurance that way? Or how about something simple like reading the direction on lawn chemicals before you put it where children will be playing?

Put your big girl panties on. You are responsible for asking questions.

I checked out United American. their products are designed to cover "gaps" in major medical coverage, clearly state the limitations of their benefits in writing, and are very easy to underwrite/issue to folks with problems. They have some excellent plans for every-day coverage but tend to be weak on the outpatient side. If you can't afford major medical coverage, I would think UA would be a good choice for a lot of reasons - but you're probably so angry you wouldn't want to hear about my research.

Bottom line, when you got your actual policy in the mail you should have read it and started asking questions if the coverage was not clear to you. I know it's a real sleeper of a reading assignment so a person needs to do it over their morning coffee and not at night right before bedtime.

sorry for your troubles, but without much thought to anything except your distress, you've made a good display of whining in public. go to the corner and cool off before you start looking for other coverage and I bet you'll have better luck.

When I signed up to be a Licensed Field Sales Representative with United American (UA), at first I felt a sense of pride and accomplishment. I just passed a state test, and took the job very seriously. I wanted my clients to be nothing less than satisfied not only with the sale of the policy, but years down the road as well. Afterall, I had gained a Missouri license to sell health and life (death benefit) policies to whomever lived inside the state and was willing to give me time to explain what the company had to offer.

I did sign a statement saying I would not participate in disparaging remarks about this company, nor its' competitors. Afterall, they do have a code of ethics to live by. So, with that in mind, I will only present you with the facts and leave it up to you to decide.

United American Insurance, a Torchmark subsidirary, has one main goal in mind, and just like any other company out there, it's to earn a profit. They have to satisfy their stockholders, or the leadership will lose its place on the board of directors...ok, so your not here for a lesson in economics...but that is and always will be the driving force, especially in this industry. This should be hint number 1. To whose benefit are insurance companies there for, your's or their's?

Whenever I showed up for meetings at the local office, it was for information and opportunities on selling, mostly the Health Care policies. Besides, the nation is in a "healthcare crisis" and it was in this industry's advantantage to capitalize on that perception. The agents would hear about who was the "Top dog" in sales for the period and how rewarding it was for those who achieved that goal, and the rest of us should follow suit as soon as possible. Then we were handed list of telephone numbers, given a guideline script on how to talk to the warm leads to make as many appointments as possible to sell, sell, sell...and sell some more! Agents would have to spend no less than 2 hours...I even heard of one agent spending as much as 5 hours a day...on the phone scheduling appointments.

When I decided for myself to not concentrate so much on sales, but rather do research on the actual policy contracts, weighing their advantages with disadvantages (the one thing I hated about sitting down at an appointment was not having a well rounded knowledge of what I was supposed to sell), the office management always reminded me that I should be concentrating on making appointments & selling policies and leaving the details of what the customer was left with to the underwriting staff because, I was brought in as a sales rep., not a research or administrative rep.

So, whenever the client would begin asking pointed questions about their coverage, before they had the chance to figure it out for themselves, it was my job to bring them back around to how important it was for them to sign up for a policy before it's too late. Even a limited policy was better than nothing at all. Basic salesmanship 101; 'NEVER let the client have the opportunity to tell you, "No".' Nonetheless, I spent a few hours of my time calling hospitals and getting price quotes on procedures on things the sales manual outlined as basic coverage. I soon learned that what the policy would cover didn't always add up to the actual cost of the facility, and what health care professionals expected to be paid. Which leads me to this very point:

There are several classifications of insurance. The type of policy United American wanted me to sell is known in the insurance industry as a "Fee For Service, Limited Pay, Hospitalization" only. We were always told, "This policy is not intended to replace Major Medical Insurance." The main selling point was to put into the customer's hand a valid Healthcare Insurance Card, and hopefully into the customer's mind the idea that they would be coverd for healthcare cost anywhere in the Continental U.S., oh and by the way, your annual premiums will never increase...Wow really? Yeah, really! And do you understand why? It's because of the limitations of the policy. You see, your premiums will never increase because neither will the amount of coverage offered ever increase. It's no secret that healthcare cost are sky-rocketing, but it was a secret that the type of policies that we had to offer were no where near keeping pace with the rate of inflation.

When I finally woke up to the fact of what I had to offer most people was inadequate, and very few people were willing to give an Insurance Salesman the time of day, I stopped trying to sell something I thought wasn't worth my effort & time, so I began concentrating on other policies that UA offerd, such as Death Benefit and Long Term Care; only to be reprimanded by my sales team coordinator that I wasn't doing my job, and that I needed to get back on track by making appointments to sell the Health Care policy. I was under the impression that I was a commissioned sales rep, with the freedom to be able to choose what hours and days I wanted to work. I may have been led to believe that during the initial interview, but the reality is, you either perform up to standard when they tell you to, or they will cut ties with you altogether.

Now, here is a question for the consumer shopping for an adequate health care insurance policy: Should this type of insurance be illegal? No, I really don't think it should be, because in reality it may be more than adequate for someone out there, just who, I'm not sure, but it may be just what they are looking for. More power to them!

What I do believe should be done is is this: Our legislators should either write laws, or enforce the current laws for FULL DISCLOSURE in a more recognizable form to the public, so you & I can make a better informed decision and protect ourselves against financial liabilities and ruin, simply because the sales reps don't have the knowledge or time to explain what you are really getting yourself into. I seriously doubt that Missouri Governor, Matt Blunt is interested in going to bat for the average citizen and raising this point with his administration. Besides, the insurance indusrty has very rich and powerful attorneys to keep the corporate profit margins at the forefront of their minds.

The insurance industry is definately not a "One size fits all". But in all fairness to the general public, unless you have the luxury of time to sit down and study the laws, the 'ins' & 'outs', to get to know what makes this beast tick, the average John & Jane Citizen can easily fall prey to a slick sales rep. whose only job in life is to get you to sign your name on the dotted line and make the stockholders happy about the CEO's & CFO's, which in turn will help pay for his/her livelyhood.

I can empathize with you. I was involved in a freak accident this past weekend on I-5. I was in a VW van with two freaks and we were smoking weed and not paying attention. We ended up ramming into a camper with 6 freaks who were also stoned.

Needless to say, we exchanged papers WITHOUT the cops!

Mine is $2500 and then they pay 80/20 most things after that, but not for all things. Some are 50/50, there are big differences if "in network" vs "out of network" etc.

Thing is that especially for surgery, the hospital should have known what your coverage would be. Every time I have had a hospital visit, surgery and such, (and I have had alot of them!!), the hospital communicates with the insurance company and everyone knows who covers what and what your part is. They then collect your part up front. Over the past 10 years or so, I have had medical bills pushing up towards the $600,000 mark or so by now. I'm lucky to still have any coverage.

My hospital would not check me in, or anything else, until they verified my insurance and that has been, for me anyway, the same procedure through the years regardless of what insurance company I had at the time.

I do agree though that alot of these companies are set up to take advantage of people with no insurance and that seem desperate for coverage.

Reading and understanding all of the fine print is imperative. If you don't understand than be sure your doc/hospital submits to your insurance company to get a pre-approval before anyone does any work.

Many companies you need referrals to see a specialist, pre-approvals for ANY hospital visits besides the ER etc etc.

Good luck with things. It is tough. I have been wiped out and started over 3 times now financially all due to my crappy health :)