I purchased accident insurance for hospital expenses as I am a competitive, year round athlete. After a bad groin tear in a hockey game, I had numerous visits, first to urgent care, then a CT scan, then multiple orthopedist visits, then an M.R.I., and followup doctor visits. This accident injury also required prescription medications.
Upon filing a claim, they make you do all of the work. You have to mail them everything, from each and every visit, to your explanation of benefits from your insurance company from each visit, and they require you obtain and send them each and every doctor note / narrative of your accident.
After this agonizing injury, all of the doctor visits, scans, and taking all of the time to perfectly compile all of the information exactly as they requested, they denied my claim.
Initial false reason for denial -
I visited an orthopedist who I had seen a year prior for a shoulder injury. At the end of the new visit for the torn groin, the doc asked "How's your shoulder". "Perfectly fine" I responded. "Okay, if you ever have issues, let us know".
I read the orthopedist's notes and he briefly mentioned he asked about the old injury.
National General manipulated the situation as though my torn groin was a previous shoulder injury.
Apparently you're not allowed to use any doctor you have ever seen before, or, you must tell your doctor they are not allowed to even slightly mention a past visit from over a year prior.
They denied the claim on those ridiculous grounds. I appealed, saying how the CT Scan for my groin, the M.R.I. on my groin, x-rays of my groin, and other visits, all entirely for my groin, clearly had nothing to do with a year-old shoulder injury. I asked them to refile the claim and for the shady adjuster to be re-trained.
Second reason for denail
After I never heard back from them for months, I called and they said that "Torn groins and glutes are not covered under this policy". I asked them how that wasn't the reason the first time. No response. I then asked them to see the policy information specifically excluding a torn groin and glute. They refuse to give you any documentation as to what is included / excluded, and told me to go to my agent who sold me the policy for information.
I went to my agent, explained the full situation, and he said that nowhere in any of their information are the injuries I sustained "excluded". The agent advised me to sue them in court.
Please, do not use this company. It is a complete scam. And a waste of money. No ethical integrity in their practices, and the appeals department is joke.
National General Accident and Health Reviews
I purchased accident insurance for hospital expenses as I am a competitive, year round athlete. After a bad groin tear in a hockey game, I had numerous visits, first to urgent care, then a CT scan, then multiple orthopedist visits, then an M.R.I., and followup doctor visits. This accident injury also required prescription medications.
Upon filing a claim, they make you do all of the work. You have to mail them everything, from each and every visit, to your explanation of benefits from your insurance company from each visit, and they require you obtain and send them each and every doctor note / narrative of your accident.
After this agonizing injury, all of the doctor visits, scans, and taking all of the time to perfectly compile all of the information exactly as they requested, they denied my claim.
Initial false reason for denial -
I visited an orthopedist who I had seen a year prior for a shoulder injury. At the end of the new visit for the torn groin, the doc asked "How's your shoulder". "Perfectly fine" I responded. "Okay, if you ever have issues, let us know".
I read the orthopedist's notes and he briefly mentioned he asked about the old injury.
National General manipulated the situation as though my torn groin was a previous shoulder injury.
Apparently you're not allowed to use any doctor you have ever seen before, or, you must tell your doctor they are not allowed to even slightly mention a past visit from over a year prior.
They denied the claim on those ridiculous grounds. I appealed, saying how the CT Scan for my groin, the M.R.I. on my groin, x-rays of my groin, and other visits, all entirely for my groin, clearly had nothing to do with a year-old shoulder injury. I asked them to refile the claim and for the shady adjuster to be re-trained.
Second reason for denail
After I never heard back from them for months, I called and they said that "Torn groins and glutes are not covered under this policy". I asked them how that wasn't the reason the first time. No response. I then asked them to see the policy information specifically excluding a torn groin and glute. They refuse to give you any documentation as to what is included / excluded, and told me to go to my agent who sold me the policy for information.
I went to my agent, explained the full situation, and he said that nowhere in any of their information are the injuries I sustained "excluded". The agent advised me to sue them in court.
Please, do not use this company. It is a complete scam. And a waste of money. No ethical integrity in their practices, and the appeals department is joke.