Complaints

• Initial Complaint

  10/07/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  My brother expired on March 3, 2024. I filed a claim a few days later. The claim is for return of all premiums paid on the policy. It has been 7 months and nothing has been done. It is extremely impossible to talk to anyone via phone. No one answers. Your call gets routed to voice mail. I've left several messages and have yet to receive a return call. I was told that they had a deadline of September 28, 2024 to have the check to me. That deadline has passed and I am still unable to get through to anyone. I solicited help from the agent who sold me the policy (who no longer works for the company), and she was able to get through only one time, a couple of months ago. They see my phone number on their caller ID and will not answer, because it's me calling. Whenever they answer, they announce who I am. Please help!!! Someone. Anyone.

  Business response

  10/23/2024

  Dear bbb,

  
  

  Code: 22389941

  
  

  There are three exclusions that would void the benefits for a member on all of our plans. One is "suicide". Two is "the member dies during the commission of a felony". Three "the member had not paid their total cost of the plan prior to them passing away".

  
  

  Our contract also states that the "claims process can take up to sixty business days from the date that the proof of death is received (death certificate) by our company, along with a photo identification of the deceased". It does not say "sixty days from the date of the members death. The sixty business days start when we receive proof in the form of a death certificate. 

  
  

  In a case like this one where the death includes two of our three exclusions; the sixty business days now turn into "at the completion of the investigation", which will more than likely take longer than the sixty days, because we have to contact outside agencies for a full report surrounding the death.

  
  

  In most circumstances claims are closed out within ten days from the date that we receive all of the required documents. We did not receive this member's documents until July 8, 2024. The standard claims process has up until September 8, 2024 to close out the claim. However, because of the manner in which this member passed away, the investigation is still pending. We are working diligently to resolve this matter.

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