ComplaintsforTruAssure Insurance Company

• Initial Complaint

  12/14/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I had a covered dental procedure completed at ******* Smiles, an In Network Provider, on 09/14/2022. I paid the Provider $3202.73 on the date of service based upon my plan benefits. Truassure processed the first EOB on 04/12/2023 paying $718.94 to the Provider with a patient responsibility of $2,328.87. In June of 2023 I received a bill from the Provider for $1,607.69 stating that Truassure reprocessed the Claim due to an error and the balance is now my responsibility. *************************** at ******* Smiles and myself both spoke with ************************* at Truassure on 11/19/2023 who advised us that the claim would be corrected and a payment of $489.29 and would be sent to the Provider. On 12/12/2023 the Provider received a Denial Claim from Truassure. We need help with Truassure correcting the claim and remitting the $489.29 to the Provider.

  

  Business response

  12/27/2023

  On behalf of TruAssure Insurance Company, this letter serves as the response to the complaint filed by a TruAssure member regarding the processing of their insurance claim.
  
  The initial claim was submitted on October 4,2022 without all the information and x-rays needed to process, and though we received x-rays later, they were unreadable, prompting a request for additional details to be provided. Following this, we received a duplicate claim, which was mistakenly processed for payment. As a result, we sent an overpayment letter to the provider requesting reimbursement for the incorrectly processed claim.
  
  Once we received the correct documents, the claim was reprocessed to allow an alternate benefit, but because the provider already had an outstanding overpayment on a previously processed claim, no payment was sent to the provider. On December 14, 2023, one of our customer service representatives explained to the member that no payment was issued due to this.
  
  The member will be issued an updated Explanation of Benefits, outlining the corrected amount owed for the procedure.Additionally, a member of our **************** team will contact the member and provider directly to advise of the corrected overpayment amount of $176.14.
  
  We will also continue to work with our team on appropriate training and process improvements for this matter.
  
  We believe the above information responds to this complaint. Should your agency need additional information, please contact *************************************.
  

• Initial Complaint

  12/06/2023

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My policy ended 12/31/22. The policy was through my insurance with the marketplace. They automatic withdrew my January Premium January 2023 after the policy was cancelled. I have called 4 times to request a refund and I have been told it was requested. One time they said they were going to overnight it. I have requested twice to speak with a supervisor. Neither time have they called.

  

  Business response

  12/15/2023

  December 15, 2023
  
  Re:BBB Review Number 20966401
  
  To whom it may concern,
  
  On behalf of TruAssure Insurance Company, this serves as the response to the above referenced review.
  
  We first want to state that the members service experience does not meet our customer experience standards.
  We apologize that the member has had to call repeatedly.
  
  We have identified an internal improvement process for refunds and will begin implementing it.
  
  The request for refund was expedited and processed on December 13, 2023. A TruAssure supervisor has reached out to the member personally to inform them and advise on timing of the refund.
  
  If additional information is needed, please contact TruAssure at *************************************.
  
  Thank you for the opportunity to respond.

• Initial Complaint

  08/01/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I have had my Dental insurance through TruAssure Insurance (Truassure Insurance Company) for several years. I continue to have automatic payments taken from my credit card each month. Starting in June I am also receiving a paper bill for the amount.Specifics for June:I received the bill on Jun 30, envelope post marked Jun 28. bill due July 1. Credit card charged the entire amount on Jun 28.Specifics for July:I received the bill on July 31, envelope post marked July 21, bill due Aug 1. Credit card charged the entire amount on July 27.On July 1 I sent an eMail to TruAssure *************************************** requesting a written explanation for receiving the bill _after_ TruAssure had charged my credit card. I never received a written explanation.Now I am facing the same thing. I believe that I am being double billed.I have automatic payments set up for other companies and if they send me a monthly bill, they will have something like "*** DO NOT SEND A PAYMENT *** you are in the Easy-Pay Aut5omatic Payment Plan". But nothing on either of the two TruAssure bills or the cover letter indicates anything like this.I have asked a friend to look at the bill and cover letter and they do not see anything indicating that I should not pay.As for TruAssure's mailing dates, how can anyone pay a bill that they receive on the last day of the month _before_ the first day of the next month? I subscribe to the **** Informed Delivery so I have confirmation of what mail I should receive each day. This also documents the dates I provided above.I will gladly forward copies of the documentation if you want it.

  

  Business response

  08/07/2023

  Good afternoon. Attached is the company response. Thank you. 

  Customer response

  08/14/2023

   
  Complaint: 20405882
  
  I am rejecting this response because:
  

  On my eMail to TruAssure dated July 1, I requested a response in writing.  I have yet to receive said response.  **** offers a service called Informed Delivery which provides individuals with daily eMails listing what mail they should receive that day.  I have fone over the Informed Delivery eMails from the month of July and DO NOT have one from TruAssure that matches the response they claim to have sent on July 3!  I ask TruAssure to provide documentation showing that a response / letter was generated and mailed.  Surely, they would have a computer log or audit trail showing the creation of the letter and its mailing.

  TruAssure's response reads like a form letter with one paragraph added.  If it is not a form letter, then why am I referred to as "the complainant" instead of by name?  I find it insulting that TruAssure could not take the time to personalize their response.

  Plenty of other companies are capable of generating a bill for informational purposes and including some text like "Do Not Pay - your account will be debited on xxxx date".  If this problem is a result of a "system update", as respondent's response indicated, I find it very hard to believe that no one in the ********************************** the various oversight committees, or their legal department thought the fact sending a bill to customers enrolled in automatic payments would be confusing!

   

  I wonder if any of TruAssure's customers received the bill, panicked, and immediately sent a payment to TruAssure.  If that did happen to one or more customers anywhere within TruAssure's service area, then I would be justified in asking the question of whether TruAssure intentionally committed Criminal Fraud?

  I ask that TruAssure respond with documentation to support their clain that they sent me a _written_ response per my eMail.

  This incident has lowered my opinion of TruAssure. I believe this is just another case of Big Business feeling that they can mistreat the customer.  ********************** tell me internally do you refer to the customer as a peasant, peon, or surf?
  Sincerely,
  
  *****************************

  

  Business response

  08/21/2023

  Good afternoon. The company response to rejection dated 08/14/2023 is attached. Thank you. 

• Initial Complaint

  12/19/2022

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I went to **************** on August 11, 2022 and had my teeth cleaned as had been previously approved by TruAssure Insurance Company. On October 10, 2022 I received a statement of account from **************** stating that the bill had not been paid. When I called TruAssure I was told the check for payment was sent and apparently had been lost in the mail. I was advised that **************** needed to call TruAssure and request the check be stopped and a new check be reissued. I did ask as advised. **************** called TruAssure and was told the check would be stopped and a new one issued. After calling Creekview Dental today December 19, 2022 and being told AGAIN that payment had not been received I called TruAssure, and was told a check had been reissued on December 7, 2022 Upon calling Creekview today no payment had been received.

  

  Business response

  12/29/2022

  December 29, 2022
  
  Re:      BBB Compliant ID ********
  
  To whom it may concern,
  
  On behalf of TruAssure Insurance Company, this serves as the response to the above referenced complaint.
  
  We apologize for the delay in payment. We contacted the providers office and updated the address in our system.
  
  After review, we determined that the reissued check was cashed on December 12th, 2022. We have reached out to the dental provider to confirm payment was received and to confirm no other payments are outstanding.
  
  If additional information is needed, please contact TruAssure at **************************************

• Initial Complaint

  01/25/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  i purchased this dental insurance policy thru the marketplace. a place where people of low income can get financial help with their insurance costs and fees. so you would think it was legit? well, it is not. i feel very stupid that i did not check on them with the BBB or reviews, but i didnt. again, i assumed being purchased thru the marketplace that they would already have checked them out? THEY did not! they flat out steal your money! i was charged $60 for 11 months. i didnt use the insurance and when i needed to in the last month i first went on their site and entered my information for them to show me participating dentists in my area. it showed just a few. i called every single one and NONE of them took this insurance which PROVES they do not have updated information, and it also proves they do NOT have a dentist in my area, and they took my money!? so then i extended the search to 75 miles fromhome! 75miles each way??? again very few choices. a few of them were multiple dentists listed to make the list seem bigger but they were working from the same office. so again, i called them ALL! i took notes as to what each one said. NONE of them told this insurance, one told me that they take Dentamax which is part of Turassure?, BUT not if i purchased my policy thru the marketplace. so i called every single listed dental office, every one, took notes-who i spoke with, date, and what they said. NONE of them take this insurance.so for 11months i paid for insurance i never had. i contacted them dec 1st and told them not to charge me again.and explained what happened.they ignored me and tried to charge me on dec 20th??anyway? i had stopped auto pays with my bank. i am cooperating and have made reports to tx **** of insurance in ******* and am working with the marketplace to have them investigated. full refund is what i want! and them stopped from operating an illegal business! i will not stop. BTW since they took my 600 bucks i never got dental work done! shame shame!

  

  Business response

  02/02/2022

  February 2, 2022
  
  Customer Relations Advocate
  ********************** of ******* &Northern ********, Inc.            
  330 *******************, Suite 3120                                                        
  *******, ******** 60611
  
  Re:      BBB File Number BBB 16674931
  
  Dear Sir or Madam,
  
  On behalf of TruAssure Insurance Company, this letter serves as the response to the complaint filed January 25, 2022 by the complainant regarding a refund of premium paid for their Preferred Plan policy with TruAssure purchased on the Health Insurance Exchange in *****.
  
  The complainant contacted us regarding this,and we responded with the attached letter. A check was mailed January 28, 2022.Please see below for a summary of TruAssures actions.
  
  TruAssure Insurance Company uses the ******** dental network. This network is referenced both within the insurance policy, on the back of the members ID card and on *********************** online dentist search, which is updated daily. Contracted dentists have a contract with the ******** Network in lieu of TruAssure Insurance Company. When calling to ask about coverage, both TruAssure and ******** should be mentioned when contacting the dental offices. Members do not have to use network dentists;they can visit any licensed dentist. TruAssure encourages using a network dentist because the member will benefit from reduced fees that network dentists agree to that translate into savings for them.
  
  In response to the concern that there were no contracted dentists in the area, TruAssure used our online search and found approximately 12 contracted dentists within a twenty-five-mile radius from the members home address on file.
  
  TruAssure agreed for refund six months of premium and cancel the policy as of May 31, 2021 as a one-time courtesy.
  
  We believe the above information responds to this complaint and concludes our handling of this matter. Should your agency need additional information, please contact **************************************

  Customer response

  02/11/2022

   
  Complaint: 16674931
  
  I am rejecting this response because: IT is ridiculous. they still stole my money. they STILL sold me a worthless policy. from the MARKETPLACE! a place where poor people get help with insurance? shame shame. they sent me half of what they owe me, and of course made it seem like it was customer well being related. like it was a gift? it is MY money! my money paid for dental insurance. **i would like to note that in their ?settlement letter to me, they stated 2 or 3 times!!! that i was free to use a dentist that was not participating with them, but i would then be out of network? first of all i dont need their permission to do this? and why would i do this? why? i signed up to use their participating dentsist. BUT...they didnt have any. not for 75 miles. i do have full documentaion of all the choices including names of who i spoke with, dates, and what they said, when they said they do NOT accept this insurance. they wrote this 2-3 times! hogwash! nobody buys insurance and then doesnt use itridiculous! a good, and honest business would have returned all of MYmoney, and apologized for the fact that i did not have any local provider. they would have given me all of MY money so i could *** it for my dental needs. this company did NOT do that. they stole my money, they waiteduntil i reported them here to even give me half of it back. then they write me and say it is them being nice to me, not that they made a mistake and sold me insurance i couldnt use, no, it was a gift. then they tell me i could use a nonparticipating dentist? very very dishonest company. i am working hard to have them removed and not referred by the marketplace. the reviews of all of the other people who have had 100% the same issue with them, and my paperwork should do the trick. the ? lawyers they have working for them are pitiful. a bunch of lying, scamming human beings who prey on the unfortunate. shame. NO, i am definitely rejecting this lame solution. i didnt pay half of my pmts, why would i be happy getting half of it back? ridiculous! BBB thank you for accepting this case,it will help me with the marketplace claim.

  
  

  *********************
  
  Sincerely,
  
  *********************

  

  Business response

  02/18/2022

  February 18, 2022
  
  Customer Relations Advocate
  ********************** of ******* &Northern ********, Inc.            
  330 *******************, Suite 3120                                                        
  *******, ******** 60611
  
  Re:      BBB File Number BBB 16674931
  
  Dear Sir or Madam,
  
  On behalf of TruAssure Insurance Company, this letter serves as the response to the rejection of the response of the complaint originally filed January 25, 2022 by the complainant regarding a refund of premium paid for their Preferred Plan policy with TruAssure purchased on the Health Insurance Exchange in *****.
  
  The complainant originally contacted us regarding this, and we provided a refund for six months premium as a one-time courtesy. A check was mailed January 28, 2022.
  
  TruAssure provided the refund as a customer courtesy and will not be providing further refund as we do not believe it is warranted given the information we provided in our initial response to this complaint and again in this response to the rejection.
  
  - TruAssure Insurance Company uses the ******** dental network. This network is indicated within the insurance policy and on the back of the members ID card, as well as on TruAssures online dentist search, which is updated on a daily basis.

  
  - Contracted dentists have a contract with the ******** Network in lieu of TruAssure Insurance Company. When calling to inquire about coverage, both TruAssure and ******** should be mentioned when contacting the dental offices. 

  
  - Members can visit any licensed dentist, not just network dentists. However, TruAssure encourages using a network dentist because the member will benefit from reduced fees that network dentists agree to.
  
  In response to the concern that there were no contracted dentists in the area, TruAssure used our online search and found approximately 12 contracted dentists located within a twenty-five-mile radius from the complainants home address on file.
  
  TruAssure canceled the policy as of May 31, 2021 and agreed to refund six months of premium as a one-time customer service courtesy.
  
  We still maintain that the above information responds to this complaint and concludes our handling of this matter. Should your agency need additional information, please contact *************************************.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩