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Combined Insurance Company

Additional Locations

View Additional Phone Numbers PO Box 91003, Chicago, IL 60680 View Additional Email Addresses http://www.combinedinsurance.com


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BBB Accreditation

A BBB Accredited Business since

BBB has determined that Combined Insurance Company meets BBB accreditation standards, which include a commitment to make a good faith effort to resolve any consumer complaints. BBB Accredited Businesses pay a fee for accreditation review/monitoring and for support of BBB services to the public.

BBB accreditation does not mean that the business' products or services have been evaluated or endorsed by BBB, or that BBB has made a determination as to the business' product quality or competency in performing services.


Reason for Rating

BBB rating is based on 13 factors. Get the details about the factors considered.

Factors that raised the rating for Combined Insurance Company include:

  • Length of time business has been operating
  • Complaint volume filed with BBB for business of this size
  • Response to 43 complaint(s) filed against business
  • Resolution of complaint(s) filed against business


Customer Complaints Summary Read complaint details

43 complaints closed with BBB in last 3 years | 21 closed in last 12 months
Complaint Type Total Closed Complaints
Advertising/Sales Issues 4
Billing/Collection Issues 10
Delivery Issues 11
Guarantee/Warranty Issues 0
Problems with Product/Service 18
Total Closed Complaints 43

Customer Reviews Summary Read customer reviews

8 Customer Reviews on Combined Insurance Company
Customer Experience Total Customer Reviews
Positive Experience 3
Neutral Experience 0
Negative Experience 5
Total Customer Reviews 8

Additional Information

BBB file opened: January 01, 1954 Business started: 01/01/1922 in IL Business started locally: 01/01/1922
Licensing, Bonding or Registration

This business is in an industry that may require professional licensing, bonding or registration. BBB encourages you to check with the appropriate agency to be certain any requirements are currently being met.

These agencies may include:

Illinois Department of Insurance
100 W. Randolph St. Suite 9-301, Chicago IL 60601
www.idfpr.com/doi
Phone Number: (312) 814-2420

Type of Entity

Corporation

Business Management
Mr. Brad Bennett, CEO Compliance Review Policyholder Services Ms. Tanya Stojanovski, Manager of Consumer Service Investigations
Contact Information
Principal: Mr. Brad Bennett, CEO
Customer Contact: Policyholder Services
Business Category

Insurance Companies Insurance Services Insurance Agencies and Brokerages (NAICS: 524210)

Alternate Business Names
Combined Insurance Co. of America

Customer Review Rating plus BBB Rating Summary

Combined Insurance Company has received 0 out of 5 stars based on 0 Customer Reviews and a BBB Rating of A+.

BBB Customer Review Rating plus BBB Rating Overview

Additional Locations

  • 111 E Wacker Dr Ste 700

    Chicago, IL 60601

  • PO Box 91003

    Chicago, IL 60680

X

BBB Customer Review Rating plus BBB Rating Overview


BBB Customer Reviews Rating represents the customers opinions of the business. The Customer Review Rating is based on the number of positive, neutral and negative customer reviews posted that are calculated to produce a score.

Customer Review Experience Value
Positive Review 5 points per review
Neutral Review 3 points per review
Negative Review 1 point per review

BBB letter grades represent the BBB's opinion of the business. The BBB grade is based on BBB file information about the business. In some cases, a business' grade may be lowered if the BBB does not have sufficient information about the business despite BBB requests for that information from the business.
Details

BBB Letter Grade Scale

BBB Rating Value
A+ 5
A 4.66
A- 4.33
B+ 4
B 3.66
B- 3.33
C+ 3
C 2.66
C- 2.33
D+ 2
D 1.66
D- 1.33
F 1
NR -----
Star Rating scale

  Average Score
5 stars 5.00
4.5 stars 4.50-4.99
4 stars 4.00-4.49
3.5 stars 3.50-3.99
3 stars 3.00-3.49
2.5 stars 2.50-2.99
2 stars 2.00-2.49
1.5 stars 1.50-1.99
1 star 0-1.49

BBB Customer Review Rating plus BBB Rating is not a guarantee of a business' reliability or performance, and BBB recommends that consumers consider a business' BBB Rating and Customer Review Rating in addition to all other available information about the business. If the BBB Rating is NR then only Customer Reviews are used for the Star Rating.

Complaint Detail(s)

5/13/2016 Problems with Product/Service | Complaint Details Unavailable
4/5/2016 Problems with Product/Service | Complaint Details Unavailable
3/30/2016 Problems with Product/Service | Complaint Details Unavailable
3/25/2016 Billing/Collection Issues | Complaint Details Unavailable
3/17/2016 Advertising/Sales Issues
3/17/2016 Billing/Collection Issues
3/10/2016 Problems with Product/Service
2/28/2016 Problems with Product/Service | Complaint Details Unavailable
1/8/2016 Billing/Collection Issues
1/8/2016 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: since I have had you from day one it has been nothing but headaches and lies from the phone personel. first I asked can my payment start from 10/4/2015 cause I get paid on the 3rd of the month they said ok but double billed me and then when I asked for a refund or put the double billing in august to January payment the supervisor said she can put the request in but couldn't quarentee it. and then the first time I tried to register a claim I got got off and then I called and the lady on the phone said you can send in the paperwork from the er visits and you don't need to call. with it. cause they can set it up with the paperwork. so I asked for the address for the paperwork and no one sent it to me. so I sent it to Chicago address and then I called and the rep told me since you send it to the Chicago address it will be thrown away. I asked can you call them or send an email she said that this area don't accept calls or email it is the payment center. they will send your paperwork back or throw it away. she was so unhelpful. I was fed up. you me no one speaks to each other she basically said yes. so I asked for a supervisor and she said they will forward to the right department. then on the 4th of december up recoeved 54 pages and I resent the paperwork again. as of today nothing has been done. and I asked for you to contact me by email or text once it was done and today when I called it was turned off by someone. so I had to get it done again. and there was a check for 150 mailed on 12/15/2015 and yesterday I received a letter date 12/2 /2015 and 12/16/2015 and no check no one cares. I spoked to mary Crawford yesterday and she was asking for paperwork from dr jones and I asked for her to call me when received. they faxed it yesterday. and as far as the releaseof information authorization I sent it a week ago for the same claim but nothing was done. and I fax a general one again. so I have been doing double the work. it has been me doing all the work

Desired Settlement: since I have had you from day one it has been nothing but headaches and lies from the phone personel. first I asked can my payment start from 10/4/2015 cause I get paid on the 3rd of the month they said ok but double billed me and then when I asked for a refund or put the double billing in august to January payment the supervisor said she can put the request in but couldn't quarentee it. and then the first time I tried to register a claim I got got off and then I called and the lady on the phone said you can send in the paperwork from the er visits and you don't need to call. with it. cause they can set it up with the paperwork. so I asked for the address for the paperwork and no one sent it to me. so I sent it to Chicago address and then I called and the rep told me since y

Business Response: Please see attached document for our response.

12/6/2015 Problems with Product/Service | Complaint Details Unavailable
11/15/2015 Advertising/Sales Issues | Read Complaint Details
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Additional Notes

Complaint: I worked for the company years ago, so I know first hand the shady practices they're guilty of. My wife and I signed up when I worked there. Many of the policies seemed beneficial since she has allot of health problems that keep her wheelchair bound and give us regular trips to the ER. After many unpleasant experiences with the, then district manager; Janice ************ and my co worker at the time Keith ******** we decided to cancel all of our policies. I sent in the necessary paperwork to the Bedford NH office. I resigned shortly after due to inappropriate comments about my wife and her disabilities. I knew from experience that the Bedford office was known for being inefficient in part due to leadership issues. With this in mind, I called on three seperate occasions to make sure we would not be billed. After being reassured I dropped the issue. My wifes health plummeted, which left us homeless due to a lack of services and work. amist the chaos it had not occurred to me to keep checking statements for unauthorized charges. I just recently got a notice in the mail from combined wanting more money for policies that, again, had been cancelled on 09/23/14. this has left us with even more debt. due to bounced checks and a negative bank balance.

Desired Settlement: I desire a full refund of the 914.55 that is owed. I'm a fair and honest man who just wants to put this behind us. If they re willing to reimburse us for the overdraft fees, bounced checks, and emotional damages from discrimination when I was employed that would be appreciated and would show that there is still some integrity in the once honorable company. If this is not the case however, my main priority is the 914.55

Business Response:

October 30, 2015

Better Business Bureau
330 N. Wabash Avenue, Suite 3120
Chicago, IL 60611-7621

Complainant ID #:       94576058
Consumer:                  Justin ******

Dear BBB Customer Relations Advocate:

This letter is being written in response to your inquiry of October 27, 2015.

Privacy concerns prevent us from discussing the details regarding Mr. ******’ inquiry. However, we are able to state that he will be receiving two separate responses from our company. Our department will respond to his refund request concerns. However, as we are not in a position to discuss the concerns he raised regarding his employment, our Human Resources department will respond to that portion of his inquiry.

We are mailing our response to the Post Office box he referenced in his letter.

If you have any questions, or if we can be of further assistance, please let us know.

Sincerely,




Paul ******, Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
Direct: ***** ********
Toll Free: (800) 663-2422 / Ext 18731                
FAX: (312) 351-6910                                                                                                  
Case #4760174

NOTE: WE TRIED TO UPLOAD THE ABOVE LETTER TO YOUR WEBSITE ON 10-30-15, BUT THE SITE WAS DOWN.

11/14/2015 Billing/Collection Issues | Complaint Details Unavailable
11/2/2015 Delivery Issues | Read Complaint Details
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Additional Notes

Complaint: I am filing this complaint as power of attorney for my elderly mother who is a New York consumer with 30 year policies with Combined Life Insurance for Accident and Sickness. My mother recently went through breast cancer, and Combined Life refused to pay out benefits clearly articulated by contract, for which a complaint was already filed. My mother also fell and broke her back, and was eligible for a physicians' visit payout clearly stipulated by the insurance contract, which Combined not only refused to pay, but for which a claims representative willfully denied existed,in a manner which was vehemently belligerent (thus winning her my "most ignorant customer rep award EVER", while insisting on paperwork and additional documentation when the proper claim form had been fully completed and signed by the physician, in order to stall payment on the claim (as Combined has repeatedly done for both my mother's policies and my own across years), making the process of obtaining benefits clearly articulated by contract, as difficult as possible, during a very difficult emotional and physically demanding time. In short, New York has no bad faith laws and no consumer protection, and thus bad faith insurers like Combined can operate with anonymity, defrauding elderly people of benefits for which they've paid for a lifetime. Unconscionable. Their customer service staff are beyond rude, fail to respond, deny knowledge of documents confirmed with return receipt, certified mail, or by fax verification, and willfully and repeatedly stall claims. This has happened again and again. While I do not expect recovery on this claim, I do want other unsuspecting consumers to know this is not an insurance company you EVER want to do business with, as in the long term, they are unreliable, if not criminally negligent in their actions. Further, there is a website dedicated to consumer reviews of "micro policy" insurers which clearly shows Combined Insurance as a bad faith insurer on a national basis. In relation to the balance owed, the contract states under Section F...."If because of injury and within 90 days of the accident that caused the injury, you require treatment from a physician, Combined will pay the benefit amount shown in the Schedule under Section F for any one injury.

Desired Settlement: For this instance, $75.00 is owed.

Business Response: October 20, 2015

BBB Serving Chicago & Northern Illinois
330 N Wabash Ave Suite 3120
Chicago IL 60611-7621

*** **** ********** *********
********* ****** *****
To whom it may concern:

Thank you for your correspondence regarding your complaint ********** referenced above.

In accordance with our Privacy Pledge and as well as HIPAA (Health Insurance Portability and Accountability Act), it is our goal to protect all confidential policyholder health information, specifically regarding claims. As such, our Claim department has responded directly to our customer as her inquiry was regarding her claim. Please be advised that on October 16, 2015, a letter was sent to *** *****, addressing the concerns expressed in her letter to your office.

Should you have any questions, or if we may be of further assistance, please let us know.

Sincerely,

***** *****
******** **** ********* ******* ** *** ****
******** ******* **************
************ ********
**** ********************** *****
**** ***** ********
**** ********

Business Response: October 27, 2015


BBB Serving Chicago & Northern Illinois
330 N Wabash Ave Suite 3120
Chicago IL 60611-7621
*** **** ********** *********
********* ****** *****

To whom it may concern:

Thank you for contacting us regarding the additional correspondence you received from the consumer, in reference to your Complaint Case ********* listed above.

We understand that the consumer indicated that she did not accept the response from the business and there was no response received. Our Claims department confirmed that the letter was mailed to *** ***** on October 16, 2015, and we regret to hear that it was not received. Today, another letter was mailed to *** ****** explaining what information is needed in order for us to review her claim for benefits. Due to HIPAA, we are unable to forward copies of these letters to your office without a HIPAA authorization from the insured.

Should you have any questions, or if we may be of further assistance, please let us know.

Sincerely,


***** *****
******** **** ********* ******* ** *** ****
******** ******* **************
******************** **** ********************** ***** **** ***** ******** ********************

Consumer Response: (The consumer indicated he/she DID NOT accept the response from the business.)
No resolution was offered, and just more jargon. My response to their letter, which they alleged would satisfy the matter, did nothing more than claim they didn't have knowledge of the outstanding monies owed, and/or that the excessive information required for a standard office visit payout had not been received from the doctor (who doubtless has better things to do). Regardless....Combined Insurance continues to willfully refuse to comply with the policy language and to intentionally, and in bad faith, refuse to pay on legitimate claims. (Back **********)

11/1/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I decided to cancel my accident policy June 19, 2015 in writing. I was granted a refund. I am tired of sale reps coming to the door unannounced and getting phone calls every few weeks or calls a few days apart. I called Combined 9/25/15 to have my cell number removed from being called. The representative got permission from his supervisor to remove my number, but he did not verify my address or policy number so I doubt he did anything. I was told I wouldn't get more calls. I logged into the Combined website tonight and deleted my mobile number myself hoping it helps. Rather than trying to gain new business, Combined keeps bothering the policyholders they do have. They say the yearly review is "mandatory," when it is not. They even try to sell me an additional policy saying it was cheaper than what I had. It overall would have cost me more. They wanted to add an illness plan and combine it with accident. I would have gotten accident slightly cheaper, but when they added illness in, it would have cost even more than the accident policy alone. They hoped I would not understand. They kept saying it was cheaper. When I asked to downgrade my policy, one of the reps sighed. Combined is very pushy and will not stop calling. I got a message from Sunny or Sunday, market manager, they had to get me back on today, which was last Friday. What do they not get that I cancelled and do not return their calls. I do not answer the door either.

Desired Settlement: I do not want any more agents coming to my home or calling me. I do not want a policy with them and am not interested in buying any. I do not want to be harassed and bothered.

Business Response: October 20, 2015

Better Business Bureau
330 N. Wabash Avenue, Suite 3120
Chicago, IL 60611-7621

Complaint ID#: ********

Dear Better Business Bureau:

This letter is being written in response to your email of October 13, 2015.

While our policies have been traditionally sold in person by way of door-to-door sales, our home office is also reaching out to customers as well. In brief, we contact current and past customers in order to discuss new policies. However, it is not our intention to overwhelm or alienate a customer.

Based on Ms. ******' report, it appears that we were rather aggressive in our approach. Please ask Ms. ****** to accept our apologies for any concern or inconvenience she may have experienced as a result of this situation.

In accordance with Ms. ******' request, we have taken steps to discontinue all future contact with her. Specifically, we have informed sales management that all field agent contact is to be stopped and we have also flagged her former policy record to prevent telephone and mail contact with her.

While we trust that this letter satisfactorily responds to your inquiry, if you have any questions, or if I can be of further assistance, please let me know.

Sincerely,




**** ******, Senior Coordinator
Combined Insurance Company of America
Consumer Service Investigations
Direct: (**** ********
Toll Free: (**** ******** * *** *****
FAX: (**** ********
Case #*******

10/26/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: The policy I purchased covered any injuries sustained, paying $1500/month. I filed a claim for an injury sustained. Combined delayed this claim by requesting additional medical documents. I provided all documents requested along with a signed waiver allowing Combined to request any documents from my doctor. Combined continued to delay and ignore my claim. Two years later, with Combined only paying a total of $25.00 on this claim, one of their employess, Wendy ******** assisted me with attempting to be properly compensated for this claim. Ms ******** informed me of documentation needed to finalize this claim for full compensation owed. I once again provided all documents requested. Combined once again continues to delay and ignore this claim. I have been in contact with Ms ******** via email. Each time I inquire about the claim I am told that she will call again and again to the highest person possible and I'm still waiting for an answer.

Desired Settlement: Full compensation with additional for any legal costs and or fees

Business Response: Initial Business Response /* (1000, 5, 2015/10/14) */ To Whom It May Concern: In accordance with our Privacy Pledge as well as HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential ************ information, specifically regarding claims, while continuing to provide high quality service to our customers. As the disclosure of Mr.******** claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that our Claim Manager has already spoken with Mr.****** and Mr.****** has further been contacted through the mail. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ***************** Senior Coordinator Combined Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

9/11/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: CANCELLING POLICY AS OF WEDNESDAY, AUGUST 19, 2015

Desired Settlement: DesiredSettlementID: Refund I DON'T WANT THEIR SERVICE. I JUST WANT MY REFUND IMMEDIATELY.

Business Response: Initial Business Response /* (1000, 5, 2015/08/28) */ August 28, 2015 Better Business Bureau 330 N. Wabash Avenue, Suite 3120 Chicago, IL XXXXX-XXXX Re: Complaint ID #: XXXXXXXX Consumer: ******** ****** Dear BBB Customer Relations Advocate: This letter is being provided in response to Ms. ******'s August 19, 2015 inquiry to your office. Prompted by your inquiry to us, we reviewed our records and learned the following. Ms. ****** applied for a policy through an agent of our company on August 13, 2015. On August 19, 2015, she faxed a signed policy cancellation/refund request letter to our company. On August 25, 2015, we mailed her a full premium refund check. On that same day, we also mailed a letter to her in a separate envelope in order to acknowledge that her policy was cancelled and that a full premium refund had been processed. Her policy is now being considered null and void from the beginning. While we trust that this letter satisfactorily responds to your inquiry, if you have any questions, or if I can be of further assistance, please let me know. Sincerely, ***********, Senior Coordinator ******** Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case #XXXXXXX

8/31/2015 Delivery Issues | Read Complaint Details
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Additional Notes

Complaint: I'm a policy holder Accident&Sickness that I was approved. Ive sent over claims there not paying,requesting info not needed. no customer service is allowed after 2 years they state Im a employee and customer service cant help me Ive been employee for 3 years since 2013 and this all changed 2015 why ??? Now i deal with a ****************** And she will not answer my questions why the change and why are they requesting medical info that is not pertaining to my claim she wanted me to sign a any and all authorization i said no I need to know who where what and which claim. I have not heard no news on this since I stated I have the right. Next thing in our policy i purchased in 2012 there is a 1 year preexisting and claims I'm sending over are 2015 so there would not be needed medical requesting from 2012 for this claim. Also there treating my husband claims the same as mind asking for medical that don't apply. When I call the call center like I had in the last 2 years i was able to get info on claim now they tell me I cant speak with them as I'm a employee I tell them I have been employee for the last 2 years why now also I'm a customer and I should be treated the same as any other customer I pay premium and I want same services i was promise I believe they either are trying to drop me as a client as they think I'm a liability to them and I do have a work comp case pending and this is why the rules changed But they need to stand by what they sold and promise in there contract and if i don't follow there rule I don't receive payment on my clams that were sent over there is a 7 to 10 day process for claims in my case I have claims pending since June 20 and still have not been paid out 2015. I believe they are asking me to break the hippa law and requesting medical that was requested when I was approved of policies. i feel there trying to find a way to kick me off my policy. I want to be treated Fairly and question answer and payment paid out in a timely manner and be able to get stasis on file thru the normal call center like each and every other client. I had my territory manager call to get update and he does not know why there doing what there doing and is not able to help and I have no superior either to go to There is to be a divisional Manager and we have no one. I have a file that shows they produce in a timely manner prior to there new change on me being a employee I don't know where that has a difference in customer service provided. Each and every time you call your message is being recorded so they were aware i was employee 2013 as they are holding money in escrow while I'm out on medical they send me my income weekly and they took me off the agent contact list so they were total aware I was employed and now 2015 this what there using for there reason. I believe the reason there requesting medical and ask for hiv records etc to try to remove from being a holder to a policy that i have collect payment against. There is A two year situation in policy that they have a right to revoke police. My husband and myself have sent all medical documentation over that has been requested and still nothing is paid out

Desired Settlement: Want payment and treated fairly and them to follow there policy contract

Business Response: Initial Business Response /* (1000, 5, 2015/08/21) */ August 21, 2015 BETTER BUSINESS BUREAU 330 N WABASH AVE STE 3120 CHICAGO IL XXXXX-XXXX RE: YOUR CASE #: ********* CONSUMER: **************** Dear Sir/Madam: Thank you for your correspondence, referenced above. Please be advised that we have contacted Ms. *************** directly and provided a written response, addressing the concerns expressed in her inquiry to your office. Due to HIPAA (Health Insurance Portability and Accountability Act), it is our goal to protect all confidential ************ health information, specifically regarding claims. As such, we are unable to provide additional information to you at this time. Should you have any questions, or if we may be of further assistance, please let us know. Sincerely, *********** ******** Insurance Company of America Consumer Service Investigations Direct:(XXX)XXX-XXXX Toll Free:XXX)XXX-XXXX/Ext XXXXX FAX:(XXX)XXX-XXXX Case #XXXXXXX Initial Consumer Rebuttal /* (3000, 7, 2015/08/21) */ (The consumer indicated he/she DID NOT accept the response from the business.) Not all of it has been paid out yet. As soon as BBB report then they started process of claims not all claims have been paid out and then we have a disagreement that my claims have to do with a elective surgery that does not pay which is correct but i then followed up with a sickness and they are stating they don't need to pay this as it was from a elective my sickness is stated from doctor as doctors note show this is still a sickness and it needs to be paid out on policy since i carry a sickness policy i understand they will not pay for the elective surgery but that has no effect on the after effects. They paid on some of them as if they were paying out on a policy that should not be paid out on but they were doing it on there kindness, that does not work in the real world. also there is a dispute on the amount that needs to be paid . They paid out on a minor then a major my procedure was a major not a minor it was done in a ambulatory settings you don't do a procedure like i had in a doctors office where there is Novocain and a surgical needle injected in body to drain fluid. so we still have the difference on this situation and I also don't feel I'm being treated as any other customer as They state i need to be with certain people as I'm a employee of theirs which 2 years that was not the issue at all i was able to call speak with call center and get info on claim now I'm not allowed As employee of company I have to have it handled different if this was the case why was this not in my employee contract and why 2 years go by and its now different this is discrimination and i pay for my policies as any other client. I want fairness and claims be paid out as policy shows Final Business Response /* (4000, 9, 2015/08/28) */ August 28, 2015 BETTER BUSINESS BUREAU 330 N WABASH AVE STE 3120 CHICAGO IL XXXXX-XXXX RE: YOUR CASE #: XXXXXXXX CONSUMER: *************** Dear Sir/Madam: Thank you for your follow up correspondence regarding the additional information you received from Ms. ******** on August 21, 2015. Our Claims department has further reviewed Ms. ********'s additional inquiry and concerns, and mailed an explanation letter today. We have asked Ms. ******** to contact the adjustor directly if she should have any further questions. If we may be of further assistance, please let us know. Sincerely, *********** ******** Insurance Company of America Consumer Service Investigations Direct: (XXX)XXX-XXXX Toll Free: XXX XXX-XXXX/Ext XXXXX FAX: (XXX) XXX-XXXX Case#XXXXXXX/XXXXXXX

7/9/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: I had a personal accident policy. Mr Barnard described the family policy. We decided to switch to the family policy. He wanted my husband to be the primary person on the account and not me. He coached us how to cancel my policy without mentioning we started a new one. I specifically asked him about coverage. I wrote the answers down on the info sheet he provided. After the first claim was denied, I researched more and found he lied about the coverage. The actual policy was different than he described. Example 1: I asked if Urgent Care was covered instead of a hospital. He told us yes. In fact, it is only covered IF associated with a hospital. He did not specify that. Example 2: I asked about accessories benefit. He said "anything you didn't go in with" would be covered. In fact, only a few certain accessories are covered. Splints are not. Example 3. He said a cab would be covered under transportation. In fact, the policy only covers transportation over 100 miles. In April 2015, my son was injured playing soccer so I took him to the closest Urgent Care. He had a broken finger and left with a splint. He had 2 follow up apps with an orthopedic doctor. I filled a claim for the Urgent Care which would be a payment of $50. The fracture would be payment of $125. The splint would have been a $100 payment. The follow up appt would pay out $25 for each visit for a total of $50. For a final total of $325. I received payment only for $125 for the fracture. I talked with the customer rep on 4/1/15 (Reid and then manager Tyra Soto), who said the urgent care was not covered because it was not associated with a hospital. The accessory was not covered. And lastly, the follow up appointments were not covered because the initial visit was not covered. IF the sales representative had told the truth, I would have gone to a Children's Hospital facility even though bit farther, thus the payment of $50 and follow up visits of $50 would have been paid out. If the salesman hadn't lied, we would have gotten $100 for the finger splint. I am asking for the $200 we missed out on because of the misrepresentation of **** ******** Once I knew he had lied, I took my son to the hospital affiliated facility for a subsequent injury that hopefully is fully covered. I also used the BBB website to get information to contact ******** Insurance directly prior to deciding to file a claim. As directed, I called ****** ******** three times. The number of (XXX) XXX-XXXX. I left a message each time with my phone number and name and breif description. He never returned a call over the 3 week time period.

Desired Settlement: Had I known he lied, I would have gone to the hospital affiliated urgent care and subsequently received the $50 fee and 2 $25 (total of $50) follow up payments. I want the appliance covered payment because he lied. I had the exact quote he said written on my notes. So now I am asking the BBB to assist in 2 things. 1. Reimbursement of the $200 lost due to misrepresentation and 2. Permanent BBB record that one of ******** Insurance's salesman misrepresented policy coverage. If I decide to keep the policy in spite of the misrepresentation, I will do know the exact terms of the written policy and not his spoken words or my written notes from his statements.

Business Response: Initial Business Response /* (1000, 5, 2015/06/26) */ RE: Your Complaint # XXXXXXXX: Consumer: **** L *** To Whom It May Concern: In accordance with our Privacy Pledge as well as HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential policyholder information, specifically regarding claims, while continuing to provide high quality service to our customers. As the disclosure of Ms. ***'s claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that we have mailed correspondence directly to Ms. *** addressing the concerns expressed in her inquiry to you. She should receive our letter within the next 10 business days. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Coordinator ******** Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX Initial Consumer Rebuttal /* (3000, 7, 2015/07/08) */ (The consumer indicated he/she DID NOT accept the response from the business.) I am still disappointed that they did not honor what the salesman promised. I understand I will not receive the monetary amount. I want it on record though that the salesperson lied and everyone must read every single word on the contract right away to find what was lied about and what is true.

6/23/2015 Billing/Collection Issues | Read Complaint Details
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Additional Notes

Complaint: My shoulder was injured in an accident and I was under Dr's care for many months due before the surgery was scheduled. Surgery is never the 1st option. This was explained when the claim was filed and backed up by the Doctor's report. I am now being told that they are refusing to pay due to the length of time between the original injury and the actual surgery. I have been under the Doctor's care throughout the entire time. This is the second time they have refused a claim. Yet they continue to bill me.

Desired Settlement: I believe that since they will not pay as their policy promisies (for the second time) That they should refund the premiums that I have paid them for the last 20 years. I have even left 2 detailed voice messages as your website had suggested before filing this complaint. They have no desire to fulfill the terms of their own policies and I believe this may come under Fraud.

5/25/2015 Delivery Issues | Read Complaint Details
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Complaint: there, she introduced this Critical care policy which covers several chronic conditions including heart disease. I had no history but my fathers family does so I thought it was a good investment. I had never had any pre-existing conditions at this point. On 2/23/2015 I had a rare type of heart attack that occurs in young otherwise healthy people. I filed a claim and they stated they needed to send a form to my physician requesting 2 yrs of history to prove I had no pre-existing conditions. I notified my MD so he could watch for it. By 4/10/15, he still had not rec'd a form. I called and by late pm was able to have one faxed to him. It was not a simple form. They wanted 5 yrs of medical records from my chart. I confirmed this was faxed to them by 4/16/15. On 4/14/15 I received an email second notice they had not received requested info and if they didn't, they'd assume I wanted to withdraw my claim request. Turns out they were waiting for the same form from the cardiologist that never saw me before the heart attack so never sent it back since he had no records. They knew he had no records, but rather than tell him to just indicate that, they'd rather hope they can cancel my claim. I called him to send in the form which he did on 4/24/15. So since 4/24/15 they have had all the records from the hospitalization (since the initial claim submission) and all my medical records for the last 5 years showing normal annual physical, lab values, blood pressures, & EKGs. Only 26 pages total over 5 years. Doesn't indicate a patient with medical problems. It's now 5/06/15 and they claim they can't approve it yet. They're still reviewing it. On 5/4/15, I received yet another 3rd notice warning of cancellation. They are unnecessarily delaying payout for people who are supposed to be recovering.

Desired Settlement: Immediate payout of claim for full contractual value

Business Response: Initial Business Response /* (1000, 5, 2015/05/13) */ May 13, 2015 Better Business Bureau 330 N. Wabash Avenue Suite 3120 Chicago, IL 60611-7621 Re: Your Complaint Number: XXXXXXXX Consumer: ****** **** Dear Ms. *******: This letter is being written in response to your inquiry of May 7, 2015. The policy Ms. **** discussed in her inquiry to your office was issued on November 10, 2014. As her loss occurred within the first year of the policy issue date, our Claim Department began a standard pre-existing condition investigation. Such investigations begin by writing to the insured for a signed and dated authorization and often include a request for a list of physician's names. After her claim was initially received in our mail room on March 3, 2015, the adjustor wrote to Ms. **** and asked her for a signed authorization and a list of physician's names. The requested information was received on March 30, 2015 and on April 2, 2015 letters were mailed to two of her doctors. At that time, a courtesy letter was mailed to Ms. **** regarding the claim status. After sending a second request letter to one of her doctors on April 20, 2015 and an additional request by fax to the same doctor on April 21, 2015, the records from that doctor were received on April 24, 2015. On May 1, 2015, the claim file was sent to our Medical Director for review. On May 8, 2015, a claim benefit check was issued under the new policy. However, in reviewing the file for this response, a claim manager noted that an incorrect benefit was provided. An additional payment was issued to Ms. ****. The combined total of the initial (incorrect) payment and the additional payment served to provide the maximum benefit payable for her loss under her new policy. (It is also important to note that an additional benefit was provided under another policy. The additional benefit was included in the initial benefit check of May 8, 2015.) Ms. **** also indicated that she was receiving multiple emails. These emails were sent through our Vodafone system, a system that was designed to provide automatic claim updates. The Vodafone case was closed on May 13, 2015, so Ms. **** will not be receiving any more emails regarding her claim. We regret that Ms. **** believed that her claim was being delayed intentionally. Please assure her that a routine claim investigation took place because her loss happened to be within the first year of the policy's issue date. Once the response was received from her doctor, the records were forwarded to our Medical Director for review and her claim was paid. While we trust that this letter satisfactorily responds to her inquiry, if you have any questions, or if I can be of further assistance, please let me know. Sincerely, **** Binder, Senior Coordinator Combined Life Insurance Company of New York Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case #XXXXXXX

5/1/2015 Billing/Collection Issues | Read Complaint Details
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Complaint: This letter is regarding Policy Numbers TXXXXXXX and TXXXXXXX. I am requesting that you immediately discontinue these policies and refund my automatic withdrawals from this account. Additionally, I am requesting a refund to the previous withdrawals, in the amount of $128.87 on 3/25/15, $128.87 on 1/27/15 and $56.87 on 2/25/15. Per your policy, I would be entitled to sick pay, not related to a work injury or pre-existing condition. I submitted a claim for services, which was denied, prior to any conversation or verification of the claim information. Due to the lack of contract agreement and clear violation of your policy and the agreed upon terms, I am requesting an immediate refund and cancellation of any further policy.

Desired Settlement: The business needs to refund the debited amount and discontinue any future services or financial obligations.

Business Response: Initial Business Response /* (1000, 5, 2015/04/20) */ To: ******* ******* Dispute Resolution Specialist RE: Your Complaint #: XXXXXXXX Consumer: ******* ******* Dear Ms. ******* In accordance with HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential policyholder health information, specifically regarding claims, while continuing to provide high quality service to our customers. As the disclosure of Mr. *******'s claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that our Claim Department has contacted Mr. ******* directly to discuss his claim and we have honored his request for cancellation of his policies. If you have any questions, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Coordinator Combined Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

4/17/2015 Delivery Issues | Read Complaint Details
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Complaint: Dear Representative, I have had difficulty in receiving payment for my medical needs and ******** through this insurance company. My cancer policy, which was paid in full as of 2010, is suppose to cover any ********, medications and various forms of medical treatment for the rest of my life. I have submitted all of the pathology reports, the diagnosis code and forms from my doctors at ********* ****** in ******** to this insurance company since the fall of 2014. I have talked to a **** ******** on the phone and she stated that after receiving the pathology report she could get my claim form processed and yet after everything regarding my cancer diagnosis has been sent to Combined, they continue to state that they need more information. I am needing assistance in finding out if their practices are illegal. According to my policy, I am entitled for payment for numerous services regarding my illness as listed in my policy.

Desired Settlement: DesiredSettlementID: Other (requires explanation) I would like to have reimbursement for my medical expenses regarding my disease.

Business Response: Initial Business Response /* (1000, 7, 2015/04/06) */ Our previous response included a "typo" in the first paragraph which listed an incorrect policyholder name. Below is our corrected response. To: ******* ******, Dispute Resolution Specialist RE: Your Complaint #: XXXXXXXX Consumer: ***** *** ***** Dear Ms. ****** In accordance with HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential policyholder health information, specifically regarding claims, while continuing to provide high quality service to our customers. As the disclosure of Mr. *****'s claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that we have mailed correspondence directly to Mr. *****, addressing the concerns expressed in his inquiry to you. He should receive our letter within the next 5-10 business days. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Coordinator Combined Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

4/17/2015 Delivery Issues | Read Complaint Details
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Complaint: I Called D. ********, Had ***** Call me 3/9/15 was to call back in a couple days The Usual No CALL! Claim#******** Disability Policy#P*******(6/9/03)$140.94mo. Sickness Policy#N*******(4/2/97)$36.00mo. Auto pay from checking. I am a 67 yr. old Viet Man Era Vet. I Had Exposure to Agent Orange, Carbon Tetracloride, Asbestos. I was licensed, self-employed for 25+yrs doing home Improvements& Hvac work. I Started Going To *********** VAMC in 7/2011. I had Pulmonary Function test 10/19/11 by VAMC. I Started nebulizer Treatments and oral Inhaler on 10/26/11. Dr ***** who is Board certified Pulmonlogist confirmed COPD. I went to VAMC Urgent Care 3 Times From 10/11 to 1/12 for breathing Problems, Treated COPD. I was Admitted to Upper Chesapeake Hospital 2/5/12-2/8/12 I Was Treated for COPD 3 More Medications added for treatment. Since 2/8/12 I Am Mebulizer Treatments Every 4Hrs w/ Abuterol& Ipratropium. I Also Take Memetasome Furoate Formoterol Twice Daily. I Also Take An Emergency Inhaler Combivent. I have Treated By 7 Different Doctors For COPD,5 at the VAMC 2 on the outside. Imailed the First Claim Form on 2/9/11 With The MD State Disability Form With DR. ****** ***** my primary at VAMC *********** Md. He Listed 1/3/8 as disability #1 is Has Lung Disease to such an extent that Forced(Respiratory) expiratory volume for one second,when measured by spirometry, is less than one liter,or arterial oxygen tension(p02)is less than 60mm/hg on room air at rest. #3 Is unable to 200 feet without stopping to rest #8 Has a PERMANENT DISABILITY, that adversely impacts the ambulatory ability of the applicant and which is so severe that the person would endure a hardship or be subject to a risk of injury if the privileges accorded a person for whom a vehicle is specially registered were denied. I have Sent THIER FORM Completed front and back Except Doctors signature I Also Inclued State Form At least 5X in 2012 into 2013 at this period in time My Wife Was in The Hospital 4x , I had a cancer surgery, We Had 2 Deaths in the Family Had More Important Things Going On Than Fowling up on this Claim. That Form is recongied By ALL States And Federal Government Except Combined. No Place in Policy does it state in policy does state it HAS TO ON THIER FORM. I Also SENT 2 FORMS SIGNED BY 2 OTHER DRS ON THEIR FORM. This Company has used every ploy to disapprove my CLAIM. DID NOT ACKNOWLEDGE CLAIM OR Assign # to Claim. Because they don't READ OR ACKNOLIGE MAIL! CERTIFED OR REGISTERED IS THE ONLY WAY! IN 2013 THIS COMPAMY? FINALY GAVE ME A CLAIM # Person in Charge of Claim is Ms ***** First They Attacked My SS Income (Since I WAS Self employed) (I Started AT 62) Supplementing income. NEXT Was Bank Statements, Then It WAS 4yrs Tax Forms. There is not enough room to explain the Crap These People Have Put ME THROUGH. Ms ***** must get paid on Defending claims! THEY DID NOT REQUEST MEDICAL RECORDS TILL FROM VAMC AT *********** TILL 11/2015 and UPPER ********* 11/21/2015 I Went TO VAMC *********** ON 1/7/2015 OBITAINED RECORDS SENT TO SCRANTON DELIVERED ON 1/9/2015 BY CONFIRMATION BY USPO. Called Ms ***** on 1/12/2015 hasn't had time to read. Previous to this in December Ms ***** Sent me a letter Stating ANOTHER RELEASE OF INFORMATION I FAXED BACK WHY CAN'T YOU USE OR READ THE LAST 5 I HAVE SIGNED AND SENT IN THE LAST 10 MONTHS Apparantly She GOT P/O. ON FEBUARY 3 A LETTER ARRIVED TELLING ME MY PROBLEM IS ASTIMA ACCORDING TO THIER MEDICAL DIRECTOR IN WHERE EVER! NO WHERE IN MY MEDICAL RECORDS DOES IT SAY I HAVE ASTIMA,137 PAGES OF MEDDICAL RECORDS AND 14 PAGES OF PRESCRIPTIONS. READING AND COMPRENSION IS NON EXIZINT AT POS COMPANY. **** The Client Is The MOTO AT Combined I Paid My Premiums IN GOOD FAITH . APPRANTLY MS ***** QUALIFIED AS A PULMONLIGIST ON 2/9/2015 SHE ON THE PHONE TOLD ME I CANE WORK USING NEBULIZER EVERY 4 HRS. ALSO OLD ME HAD LETTER FROM MY PRIMARY CARE DR. I WAS FINE.WENT TO VA NO LETTER EXISTS. I WENT TO VAMC 3/17/15 NO LETTER ON FILE!

Desired Settlement: STOP B/S PAY CLAIM! I PAYED IN GOOD FAITH! SEND LETTER ! IF YOU HAVE LETTER FROM DR.

Business Response: Initial Business Response /* (1000, 5, 2015/04/06) */ Dear Ms. ******* Thank you for your correspondence regarding your Office's case #:XXXXXXXX. Please be advised that due to HIPAA protected information, our Claims department responded directly to the consumer's concerns, as expressed in his complaint, on April 2, 2015. If we can be of further assistance to you, please let us know. Sincerely, *********** Combined Insurance Company of America Consumer Service Investigations (XXX)XXX-XXXX Direct (XXX)XXX-XXXX Ext XXXXX Toll Free (XXX)XXX-XXXX FAX Case #XXXXXXX

3/16/2015 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: 1. Was told by sales rep my coverage would begin immediately it I wrote him a check, which I did immediately. Shame on me for not reading the policy first 2. I was diagnosed with an non invasive tumor within the time frame that contradicts the sales rep's representation. Therefore shame on me for not reading the policy before writing a check. I was diagnosed with an invasive tumor which was not discovered until after a pathology report was produced in June of 2014 after my mastectomy. This conditions was not discovered by any physician until well after Combine's 30 day waiting period

Desired Settlement: I would like them to pay the benefits due me as stipulated in my policy

Business Response: Initial Business Response /* (1000, 5, 2015/03/03) */ To: ******* ******* Dispute Resolution Specialist RE: Your Complaint #: XXXXXXXX Consumer: ***** ******* Dear Ms. ****** In accordance with HIPAA (Health Insurance Portability and Accountability Act) regulations, it is our goal to protect all confidential policyholder health information, specifically regarding claims, while continuing to provide high quality service to our customers. As the disclosure of Ms. *******' claim information is strictly prohibited, we are unable to provide any further information to you at this time. However, be assured that we will respond directly to Ms. *******, under separate cover, addressing her concerns. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Coordinator Combined Life Insurance Company of New York Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

2/16/2015 Problems with Product/Service | Read Complaint Details
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Complaint: On Sunday 11, 2015 I sent email to company to cancel. Monday 12, 2015 I sent 3-faxes and called 2 times to cancel insurance. The person on the phone at Combine told me to put a stop payment at my bank, so I did. It stopped the total payment (117.83)that they were trying to send through my bank but then they split it up sending a partial payment of 75.83 My bank stopped it. I called them again and everyone there oblivious to anything going on. I told them to stop trying to send this through my bank because I had already cancelled this several times. Just when I thought they were finally going to stop hassling me I receive another bill for $455.00 in the mail!!!! Please make this company leave me alone!!!!!

Desired Settlement: Leave me alone and stop billing me!!

Business Response: Initial Business Response /* (1000, 5, 2015/01/30) */ January 30, 2015 ******* ****** Better Business Bureau 330 Lower Wabash Avenue Chicago, IL 60611 Re: Your Case #XXXXXXXX Dear Ms. ******* This letter is being written in response to your letter of January 26, 2015. In her statement to your office, Ms. **** indicated that she made several attempts to cancel a policy with a monthly premium amount of $117.83, but that the advice she was given by our call center was to contact her bank to prevent the $117.83 payment from being collected. She then said that we split the payment and collected a partial payment of $75.83. We investigated this matter and learned the following. On January 9, 2015, Ms. **** met with two of our agents. She applied for a SickPay Plus Policy with a monthly premium of $117.83 through agent ******* ****** and an Accident and Sickness Protector Policy with a monthly premium of $75.83 through agent ***** ******** Both agents met with her at the same time. The majority of our applications are now completed electronically through iPads. When an application is completed, the agent simply uploads the application to our home office for immediate processing. However, technical difficulties prevented Mr. ***** from submitting the application for the SickPay Plus Policy. The software in his computer ultimately had to be reloaded. When the application software was reloaded, all of the data for the SickPay Plus Policy application was lost. As a result, no premium payment was ever collected for this policy. Mr. ***** told our office that when he went back to meet with Ms. **** in order to complete a new application, she said that she had already cancelled the coverage and went with another company. For the record, Ms. ******* was able to successfully upload the application for the Accident and Sickness Protector Policy. In view of the above, we did not split a premium payment and/or collect a partial payment. Instead, the $75.83 collection was the total premium amount for one of the two policies she applied for on January 9, 2015. The main challenge associated with this situation is that we had no record of the SickPay Plus Policy. While Ms. **** had paperwork associated with the policy in her possession, we had no official record of it on this end when she called to cancel it because the application was never submitted to our company (for the reason discussed above.) In the absence of documentation on our end, our call center recommended that she order a stop payment through her bank. We note that a refund of the initial premium payment of $75.83 for her Accident and Sickness Protector Policy was processed and mailed to her on January 24, 2015. However, several days later, we note that we also mailed a letter to her to let her know that her bank did not honor our initial premium collection attempt. Based on this, it appears that the refund check was mailed to Ms. ****, in error. Kindly ask her to mail the check back to our company at: Combined Insurance Company PO Box 6703 Scranton, PA 18505-0703 Ms. **** mentioned that we mailed her a premium notice where we requested $455.00. When the premium draft process is discontinued in the absence of a written request to cancel the process, a premium notice requesting a semi-annual payment is automatically generated and mailed. It was for this reason such a notice was mailed to her. She may simply disregard the notice at this point as the policy is no longer in force. While we trust that the above explanation successfully addresses her inquiry, please ask Ms. **** to accept our apologies for any concern or inconvenience she may have experienced as a result of the challenges she encountered when she attempted to cancel her coverage. If you have any questions, please let me know. Sincerely, **** ******* Senior Coordinator Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case #XXXXXXX

1/19/2015 Delivery Issues | Read Complaint Details
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Additional Notes

Complaint: For two months, I received between 4-6 calls a day from the number (XXX) XXX-XXXX. Typically, I screen calls so as not to be a target of telemarketers. As such, I ignored the calls and waited for a voicemail to indicate it was not a telemarketer. When the calls persisted for more than four weeks, I finally picked up. It was a representative from Combined Insurance wondering if I had received a paper mailer and wanted to continue my policy with them. I declined and asked to be removed from the call list. I also suggested to the representative that they leave voicemails when calling individuals and described why I had ignored the calls for so long. The representative said that they would take my suggestions into consideration (they did not note, as you will see further in the complaint that I was actually on an automatic call list).Three weeks later, I began receiving calls from the same number again. Like the first time, I received 4-6 calls a day. I tried to pick up several times to request they stop calling me, but every time I picked up, I was promptly hung up on. I looked online and found numerous forums with other frustrated individuals who were/have been/are being relentlessly harassed by this number. I called the company again and spoke with a supervisor and explained my mounting frustrations. She assured me I would be removed from the call list. I received another call last night after I hung up with her and then three more this morning. I finally picked up and asked to speak with yet another supervisor. That supervisor informed me what the other one should have - that it will take 24-48 hours for the call list to stop automatically calling me. I let the supervisor know that I would be submitting a claim to the Better Business Bureau as the way this company is handling communication can be classified as "harassment" according to the definition of the word and is a poor business practice that should be reviewed and restructured by company stakeholders and managers.

Desired Settlement: DesiredSettlementID: Other (requires explanation) I would like for Combined Insurance to address this issue publicly on their website and let others know how to remove themselves from the call list if they too are being harassed.I strongly encourage managers and stakeholders at Combined Insurance to do a quick ****** search for the phone number (*************. If they do so, it will become abundantly clear that their practice of constant harassment is not just frustrating me but myriads of additional potential customers out there.

Business Response: Initial Business Response /* (1000, 5, 2015/01/05) */ January 5, 2015 ******* ****** Better Business Bureau 330 Lower Wabash Avenue Chicago, IL 60611 Re: Your Case #XXXXXXXX Dear Ms. ******* This letter is being written in response to your inquiry, which we received on December 29, 2014. In cases where a policy is in danger of lapsing, outgoing calls are made to a customer in order to discuss possible payment options, which may simply include collecting a payment over the telephone or securing a correct credit card or bank account number for automatic draft purposes. The telephone number of the outgoing unit responsible for making such calls is the toll-free number Ms. ******** referenced in her inquiry to your office. In cases where a policy appears to be nearing a state of lapse, our call center will make outgoing calls on 10 business days in the period of one month, with up to three calls on each of the 10 days. However, they are also required to leave voicemail messages. That being said, Ms. ********' statement to your office regarding the lack of voicemail messages and the frequency of calls concerned us. Let me assure you, we forwarded a formal report to call center management regarding this matter and we have asked them to take any necessary corrective action. According to our records, Ms. ********' telephone number was added to our internal "Do Not Call" list in response to her December 17, 2014 call to our call center. Ms. ******** mentioned that she received another call the very next day, December 18, 2014. While it can take up to 48 hours before a number is removed from our system, according to our records, no further calls were made after December 18, 2014, so it appears that her number was successfully added to our "Do Not Call" list. While we regret any concern or inconvenience that Ms. ******** may have experienced as a result of this situation, we are thankful that she brought this matter to our attention as inquiries of this nature enable us to identify areas in need of improvement. We trust that this letter satisfactorily responds to your inquiry. If you have any questions, or if I can be of further assistance, please let me know. Sincerely, **** ******* Senior Coordinator Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case #XXXXXXX

12/26/2014 Delivery Issues
10/6/2014 Advertising/Sales Issues
9/29/2014 Delivery Issues | Read Complaint Details
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Additional Notes

Complaint: I obtained coverage with Combined Insurance on 10/16/2013. I took ill in the middle of December. I later saw my doctor who referred me to a specialist who later told me I had massive tumors in my stomach. I was told there were options to treat this but they may return cancerous and worse. They recommended a treatment for me that included surgery. My nurse helped me with contacting my insurance providers and she contacted combined. They told her that the surgery I was having would be covered and that once it is complete to have me fine the claim and it will be fast and accurate. Once I had surgery,and went home a week later I started on the application cause I was in alot of pain. I sent them all the information my doctors gave me and then some. MY POLICY TYPE IS ACCIDENT AND SICKNESS PROTECTOR. As on today they continue to give me and my doctor the run around. I couldn't afford to have such an outstanding bill like this. Which is why I contacted them at first. Now they are saying the doctor hasn't sent them the paperwork they need and that's not true. Today they stated the same thing and when I told them I had the paperwork from my doctor they said of we just need to make sure this wasn't preexisting. I feel this company is taking advantage of struggling families who are just trying to stay in compliance and keep health insurance. They are just not holding up there agreement on the contract.

Desired Settlement: I want them to settle my claim or I will see if they can be sued for deceptive insurance practices.

Business Response: Initial Business Response /* (1000, 5, 2014/09/23) */ September 23, 2014 BBB CHICAGO & NORTHERN ILLINOIS ATTENTION: MS ******* ****** RE: YOUR CASE#: XXXXXXXX CONSUMER: ****** ****** Dear Ms. ******* Thank you for your correspondence dated September 16, 2014 referenced above. Please be advised that we have responded directly to Ms. ****** regarding the concerns expressed in her complaint to your office. Our Claims department sent her a letter on September 22, 2014. Should you have any questions or if we can be of further assistance, please let us know. Sincerely, ***** ***** Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX)XXX-XXXX/Ext XXXXX FAX:(XXX)XXX-XXXX Case #XXXXXXX Initial Consumer Rebuttal /* (3000, 7, 2014/09/23) */ (The consumer indicated he/she DID NOT accept the response from the business.) They have not send me any information. I just contacted them at X-XXX-XXX-XXXX and spoke briefly with Maria Simon. She advised me the call was being recorder,however as I spoke with her I realized she wasn't at all familiar with the case. She asked how did I get this number and I told her to disregard and I discontinued the conversation. I stoke with several other people that work for combined insurance and it seems this is how they handle claims. The advertise quick and easy claim processing but the run you away and takes 6 to 10 months to complete. They state the goal is to assist you while you are home recovering and not able to make money. however, they do not. I filed this claim on 4/25/2014 and suffered a relapse in June due to Combined run around and explanation of benefits. I am contacting news, and various other avenues to bring attention to how the middle class is being treated by companies such as combined. We are only trying to protect our families but seem to be getting railroaded and used.THEY HAVE SENT NOTHING AND CONTINUE TO GIVE ME THE RUN AROUND AS OF TODAY Final Business Response /* (4000, 9, 2014/09/24) */ September 24, 2014 BBB CHICAGO & NORTHERN ILLINOIS ATTENTION: MS LUCILLE GARCIA RE: CASE#: XXXXXXXX CONSUMER: ****** ****** Dear Ms. Garcia, Thank you for your follow up correspondence regarding Ms. ******'s rebuttal. As indicated in our correspondence to your office yesterday, our Claims department has sent a letter dated September 22, 2014 directly to Ms. ****** regarding the concerns expressed in her complaint. Regrettably, due to HIPAA, we cannot provide information to your office regarding Ms. ******'s claim. Please advise her to allow a couple of days to receive our mail. When Ms. ****** called yesterday, I tried to establish the caller/call but she discontinued the conversation. I have called Ms. ****** this afternoon and left her a message to return my call. I will be happy to provide her with the information explained in our Claims' letter if she has not already received it. If we can be of further assistance, please let us know. Sincerely, Maria Simon Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX/Toll Free: (XXX) XXX-XXXX /Ext XXXXX FAX: (XXX) XXX-XXXX Case#XXXXXXX

9/23/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: Good day I purchased 2 policies from Combined Life Insurance company back on October 4,2013 where a sales rep from the company came to my home my application went under a rigorous 3 week under writing then my application was approved. I currently pay $240 per month in policy fees and have been doing so since October . I placed a claim in back in August resulting from an injury that happened in April 2014 I wanted to put the claim in as I was waiting to see if I could try all alternatives before because I work for myself. I went to the ER did X-rays and Sonogram of my knee I then went to my primary care she referred me to therapy I did that for awhile no help so I went to an Orthopedic doctor where I learned it was a greater problem with my knee and he advised that I would not be able to work for awhile I was left with no choice so I put a claim into combined insurance under my accident and disability policies it's been almost 2 most and believe me combined has not paid me a penny they come up with all sorts of non sense I faxed over my 1040, doctor release forms and still no response so I have been paying into this policy now it is time to collect a claim and they are pulling me through the loop hole my bills are piling up and my knee isn't getting any better I am 53 years old and I need my disability payments from combined now I am tired of the run around and the customer service agents are no help they keep asking for the same info. I need someone to help me this is not nice business practice whatever happened to the customer.

Desired Settlement: I simply need my disability claim to be processed and my checks mailed out

Business Response: Initial Business Response /* (1000, 5, 2014/09/12) */ September 12, 2014 Better Business Bureau 330 Lower Wabash Chicago, IL 60611 Re: Your Case Number: XXXXXXXX Insured/Complainant: ***** ****** Dear Ms. ******* This letter is being provided in response to Ms. ******'s inquiry to your office. Ms. ****** owns two policies through Combined Life Insurance Company of New York. One policy is an Accident and Sickness Protector Policy. The other is an Income Protector Policy. Both policies were issued October 5, 2013. On August 4, 2014, our company received Ms. ******'s claim for total disability beginning April 30, 2014. Since her policies were within the contestable period (the loss being claimed occurred within 1 year of their issue dates), our Claim Department began conducting a standard pre-existing condition investigation. However, after further review, our Claim Department noted that they previously conducted a pre-existing investigation under her prior claim. Since our company already had her medical information on file from the prior claim, the adjustor reviewed those medical records and processed her claim for benefits on September 9, 2014. Since her Income Protector Policy has a 30-day elimination period, our Claim Department issued total disability benefits from May 30, 2014 to July 30, 2014. (Disability benefits were paid to July 30, 2014 because that is the date her doctor signed the claim form.) Our Claim Department provided a claim form with their September 9, 2014 benefit check so that she may have her doctor complete the form for additional disability benefit consideration. Upon receipt of additional disability verification from her doctor, our Claim Department will give further consideration to her claim. While we trust that this letter satisfactorily responds to her inquiry, please extend our apologies to Ms. ****** for any concern or inconvenience she may have experienced as a result of this situation. If you have any questions, or if I can be of further assistance, please let me know. Sincerely, **** ******* Senior Coordinator Combined Life Insurance Company of New York Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case #XXXXXXX

7/21/2014 Problems with Product/Service | Read Complaint Details
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Additional Notes

Complaint: My name is **** ******, my policy number is WXXXXXXX, I had rigth side cuf rotary thorn surgery, at Dec.19.2013, We called the company to ask the steep we have to do, and they told us we have to wait 2 weeks after the surgery to start to fill up the aplication for the benefits, that informations was wrong, because another person told us we can filled up same day at the surgery was done, I got the first check after 6 weeks from the surgery, latter another person told me they will mail to me a check for $700.00 1st and 15th calendar day every month, that never happened, every time I called to ask abought my check, they change the information, last time I called was 6/18/2014 she told me they'll mail next day, Today is 6/30/2014 the check wasn't in my mail, I called again and she told me : tomorrow we mail to you. Thanks for your attention.

Desired Settlement: My name is **** ******, my policy number is WXXXXXXX, I had rigth side cuf rotary torn surgery, at Dec.19.2013, We called the company to ask the steep we have to do, and they told us we have to wait 2 weeks after the surgery to start to fill up the aplication for the benefits, that informations was wrong, because another person told us we can filled up same day at the surgery was done, I got the first check after 6 weeks from the surgery, latter another person told me they will mail to me a check for $700.00 1st and 15th calendar day every month, that never happened, every time I called to ask abought my check, they change the information, last time I called was 6/18/2014 she told me they'll mail next day, Today is 6/30/2014 the check wasn't in my mail, I called again and she told me : tomorrow we mail to you. Thanks for your attention.

Business Response: Initial Business Response /* (1000, 5, 2014/07/03) */ As the details of Mr. ******'s claim are protected under the Health Insurance Portability and Accountability Act (HIPAA), we are unable to release any information to your organization. However, be assured that our Claim Department spoke with Mr. ****** on this day, Thursday, July 3, 2014, and they will be writing to him directly to further address his concerns. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Compliance Coordinator Combined Insurance Company of America Consumer Service Investigations, Case XXXXXXX (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

6/23/2014 Advertising/Sales Issues | Read Complaint Details
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Complaint: I have had a policy with Combined insurance since 1999. It started out as a accident policy for my daughter. When my daughter turned 18 in 2004, was my first request to cancel this policy. All of my requests over the past almost ten years have been denied. I was told to submit a written request, I did, and still continue to have the premiums withdrawn from my bank account. I believe my final request was in 2009. I know the billing stopped at some point, because I checked my statements, and no longer saw charges, so I figured my request was FINALLY granted. In 2010, I stopped taking care of our banking, and had my husband take over all financial obligations. I did not realize until very recently that we were still being charged for insurance premiums!!! We closed this bank account about 1 week ago, and for the past several weeks, I have once again, been attempting to reach Combined in order to have the charges stopped. I've been unable to reach them. I have left a detailed message with their contact person named ****** ********, today. I am upset that my call wasn't answered, and I decided to post this complaint. I want a refund, I want Combined Insurance to stop all charges!!!

Desired Settlement: I want to be refunded all of my premiums dating back to 2009, which is the last date I attempted to stop these charges. Since 2009, there have been approximately $1,080 worth of charges to my bank account. These charges are fraudulent!

Business Response: Initial Business Response /* (1000, 5, 2014/06/11) */ See attached response.

6/3/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: I signed up for Combined Insurance Company, hurt myself ,had surgery required physical theraphy. I was told to file a claim and send all of my hospital bills and signed documents from my doctor. I faxed the information on numerous of times. i also dropped the information in the mail. It has been over 3 months and they are still requesting additional information. Each time I have my doctor complete their forms it cost me $25.00 which I don't have additional money for this nuance. I will never recommend anyone to this company. I had two polices. I have yet to collect on either policy. This is a************** company. Every time I talk with a customer service rep, it's the exact same story. Don't cancel your policy, we are working on your claim. This is rubbish.

Desired Settlement: Just to cancel my policy, this company is in the market of making money and not helping the sick and injured..

Business Response: Initial Business Response /* (1000, 5, 2014/05/23) */ See attached response.

3/24/2014 Problems with Product/Service | Read Complaint Details
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Complaint: Combined Insurance Policy NXXXXXXX My mother signed me up for a disability policy through Combined Insurance without my knowledge or consent. I have been contacted numerous times over the years at my place of employment by the local reps from Combined Insurance. When that rep was here I asked to cancel the policy and they refused because I was not the policy holder even though my name is on the paperwork. My mother passed away last month and I called Combined Insurance several weeks ago to cancel the automatic deduction on my moms bank account. I notified the rep that the person whom they were billing was deceased and to stop deducting money from her account. I also requested again to cancel the policy but the rep kept trying to get me to sign up for other things. Yesterday I received a bill from them requesting payment. I guess they do not understand the words cancel or not interested.

Desired Settlement: That Combined Insurance cancel the policy as I requested on numerous occasions and never contact me again.

Business Response: Initial Business Response /* (1000, 7, 2014/03/11) */ Dear Ms. ******* Our response to your inquiry is attached. ****** F. ***** ***** Senior Compliance Coordinator Consumer Service Investigations Toll Free: XXX-XXX-XXXX, Ext. XXXXX Direct: XXX-XXX-XXXX Fax: XXX-XXX-XXXX E-mail: ************@Combined.com

3/10/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: I sent it a claim of disability my doctor put me out of work and combined insurance company comes up with non sense regarding payment. When I signed for the plan none of this non sense was mentioned. The company is quick to take their monthly payment from my account but take over a month to pay and when the check arrives it's never what it's suppose to be. This is ridiculous and when you call customer service they are all rude and disrespectful especially the supervisors with no care for the customer situation. I had one supervisor told me out right she doesn't care about my issue as she has her own I was in awe. I'm wondering what is the protocol on payment because I was told that it's at the discretion of the adjuster so I'm left to think if the adjuster is not in a good mood then I'm screwed which seems to be happening. I need my disability payments enough of this

Desired Settlement: I simply want my disability payments

Business Response: Initial Business Response /* (1000, 5, 2014/02/14) */ February 12, 2014 Better Business Bureau 330 N. Wabash Avenue Suite 3120 Chicago, IL 60611 Re: Your Case #: XXXXXXXX Consumer: ******* ****** Dear Better Business Bureau: This letter is being provided in response to your inquiry of February 7, 2014. Ms. ****** owns an Income Protection Policy #TXXXXXXX that provides benefits for total disability while the insured is totally disabled and under the regular care of a physician. She also owns an Accident Protector Policy #TXXXXXXX and an Accident and Sickness Protector Policy #TXXXXXXX. Our Claim Department received Ms. ******'s claim on August 22, 2013. A payment was promptly issued on August 26, 2013. The payment provided the emergency room benefit under policy numbers TXXXXXXX and TXXXXXXX, the emergency room follow up visit under policy number TXXXXXXX and total disability benefits under policy number TXXXXXXX. Our Claim Department subsequently issued payments on September 17, 2013, September 27, 2013, November 5, 2013, December 6, 2013, February 4, 2014 and February 10, 2014 for additional total disability benefits and two more emergency room follow up visits. On the statement completed and signed by her physician on January 28, 2014, he indicated that Ms. ****** remained totally disabled, but that she would not be following up with him until April 17, 2014. He also stated that she was scheduled to return to work on April 21, 2014. Based on his statement, our Claim Department provided total disability to January 28, 2014 as it is our company's procedure to pay disability benefits to the date a doctor signs a claim form. In phone conversations our Claim Department had with Ms. ****** on February 5, 2014 and February 7, 2014, Ms. ****** asked that we pay disability benefits to the date we were going to process the payment, February 7, 2014. Our Claim Department made a decision to grant Ms. ******'s request. A benefit check was issued on February 10, 2014 covering total disability to February 7, 2014. However, in order for our Claim Department to review her claim for additional disability benefits, they will require verification of treatment between February 7, 2014 and April 2014. Ms. ****** indicated that she was going to wait until April 2014 and submit this additional information to our company. In her statement to your office, Ms. ****** stated that all of our Customer Service Call Center representatives were rude and disrespectful. She also reported that a supervisor told her that she did not care about Ms. ******'s issues as she had her own. We reviewed several of the conversations Ms. ****** had during the first week of February 2014. While we did not hear or detect rude and/or disrespectful behavior, we did note that Ms. ****** appeared frustrated and she commented to one representative in particular that he was not understanding the point she was trying to make. In that particular call, she asked to be transferred to a manager. He transferred her to *** ******* in our *** **** Claim Department. During the conversation with Ms. ******** Ms. ****** stated that she used to be insured through ***** and that she never had challenges with claims through them. She also stated that ***** once paid her three months of disability into the future. Ms. Gariepy said that she didn't care about ******** procedures as she had to focus her concerns on our claims and procedures. While she never told Ms. ****** that she didn't care about her issue, we discussed this matter with Ms. ******** Please extend our apologies to Ms. ****** for any concern or inconvenience she may have experienced as a result of this situation. While we did not detect any rude and/or disrespectful treatment, if Ms. ****** is referring to a particular incident during a call she made prior to February 2014, please ask her to provide our office with the representative's name and/or the date of the call to our company so that we may research the matter and take any necessary corrective action. In closing, while Ms. ****** stated that another insurance company provided disability benefits into the future, as we discussed above, our procedure is to pay disability benefits to the date a doctor signs a claim form. However, in cases where it appears that the insured will remain totally disabled beyond the date the form was signed, our Claim Department encloses a new claim form with the benefit check. We trust that this letter satisfactorily responds to her inquiry. If you have any questions, or if we can be of further assistance, please let us know. Sincerely, **** ******* Senior Coordinator Combined Life Insurance Company of *** **** Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case # XXXXXXX Final Consumer Response /* (3000, 7, 2014/02/14) */ (The consumer indicated he/she DID NOT accept the response from the business.) This reply seems very much like an attack on my credibility. The issue was not to pay into the future as I told the rep it was to pay until the date that the adjuster signed off on the claim. It was stated that it was at the adjuster discretion and that's not right if it's policy then let it be policy but Ok I will make an appointment to follow up with my doc so that my disability can continue until he seems necessary. If needs be I will submit a continuance claim form. For the record that manager was not professional with me or my disability situation. I hope I will not have any negative handling with my claims in the future because I had to file this claim with BBB.

2/24/2014 Delivery Issues
2/21/2014 Delivery Issues | Read Complaint Details
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Additional Notes

Complaint: I AM FILING THIS COMPLAINT BECAUSE COMBINED INSURANCE CANCELLED MY POLICY ON 12/5/13 AND THEN TOOK $25 FROM MY BANK ACCT ON 12/31/13 AND TOOK ANOTHER $25 OUT OF MY ACCT AGAIN ON JAN 10TH. I CALLED THEM TODAY TO FIND OUT ABOUT IT. I WAS TOLD I WASN'T GOING TO GET MY $50 BACK. I REALLY DON'T UNDERSTAND WHY WHEN THEY CANCELLED MY POLICY THEY DECIDE TO TAKE MY MONEY. THEN TELL ME THERE NOT GIVING IT BACK.

Desired Settlement: DesiredSettlementID: Other (requires explanation) I WOULD LIKE TO HAVE MY BANK ACCT REFUNDED THE $50 THEY TOOK FROM ME. KEEP THE POLICY CANCELLED.

Business Response: Initial Business Response /* (1000, 5, 2014/01/17) */ We have received your inquiry, dated January 15, 2014. Unfortunately, we're unable to locate any record of any coverage under the name of **** ********* ******. So that we may properly investigate this matter we ask that Ms. ****** provide us with the policy number to which she is referring. Once received, her request will be given our prompt attention. Final Consumer Response /* (3000, 7, 2014/01/17) */ (The consumer indicated he/she DID NOT accept the response from the business.) The policy number to which I am referring is TXXXXXXX and that response is incorrect. Final Business Response /* (4000, 11, 2014/02/10) */ We have received your correspondence, dated January 31, 2014, in which Mrs. **** ****** provided us with Policy Number TXXXXXXX. Our records indicate that on November 5, 2013 ***** L. ****** purchased Policy TXXXXXXX, reflecting an $83.37 premium, as well as Policy TXXXXXXX, reflecting a $36.83 premium, and chose monthly billing. He provided our agent with an initial one-month premium payment, which updated the policies from November 5, 2013 to December 5, 2014. Also, he completed an Automatic Premium Collection form authorizing us to automatically draft future premiums from his account, and chose the 28th of each month, as his Preferred Billing Date. The 1st automatic premium draft was generated on December 28, 2013, at which time the policy was updated from December 5, 2013 to January 5, 2014. Unfortunately, on January 10, 2014, Mr. ******'s bank returned the draft to us, unpaid. When that happened, the policy was backdated to December 5, 2013. The policy has a 31 day grace period. This means that if a renewal premium is not paid on or before the date it is due, it may be paid during the following 31 days. During the grace period, the policy will stay in force. Therefore, on January 14, 2014, a courtesy call was made to Mr. ******, in order to give him another opportunity to renew the coverage. He gave us permission to speak with his wife, Mrs. **** ******, at which time we explained that when the December 28th draft was returned unpaid, the policy lapsed, effective as of December 5, 2013. When Mrs. ****** questioned why we would bill the policy after it lapsed, we explained that the policy did not lapse until after 2 attempts were made to obtain the funds from the account. She then questioned if she would be reimbursed the bank fees incurred and we informed her that since the policy billed in accordance with the billing agreement signed by Mr. ******, we would not be liable for any overdraft fees incurred. Mrs. ****** then requested to cancel the policies and she was instructed to have Mr. ****** submit his written, signed request for cancellation and the coverage would then be canceled, effective as of December 5, 2013. We informed her that if no written request was received, the policies would remain lapsed, effective as of December 5, 2013. Our position on this matter has not changed. As the policies billed in accordance with the agreement signed by Mr. ****** no reimbursement is due. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Compliance Coordinator Combined Insurance Company of America Consumer Service Investigations, Case XXXXXXX (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX

1/20/2014 Billing/Collection Issues | Read Complaint Details
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Complaint: I went to my local emergency room after seeing my primary care physician. I got to the ER at 10:30am on 11/06/2013. I was later told that they would have to admit me because my iron levels were low and I needed a blood transfusion. I spent the next few hours in the ER until a room was ready and they finished running the EKG and the Chest X-Ray and so on. I was moved to a private room to receive care. I was given blood 2 times throughout the night. The next day I was still being monitored to make sure that my levels had gone up and I was not running a temp. I was sent to have an ultrasound to find out what was causing the excess bleeding. I returned to my room and had a few more visits from the doctors that were treating me. I have had a Policy with Combined insurance for many years and I have had been hospitalized back in 2008 for the same reasons and the same amount of time. My claim was paid then I was paid for the ER and the hospital confinement. I filed a claim a few days after I had left the hospital for the stay of 11/06/2013 and 11/07/2013. I received a check of $50 for the ER visit and was told I needed to fax over the itemized bill, which I did after I went to the hospital and got the bill. I have been going back and forth with reps for weeks with no answers on the status of my claim. I was told that my claim may not be payable because the hospital used the language" Observation Status" on the itemized bill. I asked the rep what meant for me. She said that my policy does not pay for observation stays. I asked when did this happen and where in my policy does it say that. I checked my policy and did not find any language about "observation status". I said to the rep that I was confined to the hospital and whether I was admitted or in observation status I was confined I could not leave. I went on to say isn't that what I am paying for hospital confinement. I asked how my policy paid the claim in 2008 was. She said the rep back then must not have followed up and made the decision on their own to pay my claim back them. I have been called just about every day or so and the only answer I have gotten is that they are trying to get a hold of the hospital and they haven't been able to. I called the hospital bill office and was able to get a rep so I don't understand how they can't get a rep themselves. I just want them to pay my claim for the hospital confinement and that's it. I doesn't say anything in my policy about observation and I have had my policy for over 7 years.

Desired Settlement: full payment of hospital confinement benefits that are due.

Business Response: Initial Business Response /* (1000, 5, 2013/12/27) */ As the details of Ms. ****** claim are protected under the Health Insurance Portability and Accountability Act (HIPAA), we are unable to release any information to your organization. Be assured that our Claim Department will be contacting Ms. ****** directly, in order to address her concerns. If you have any questions, or if we may be of further assistance, please do not hesitate to contact us. Sincerely, ****** L. ******* Senior Compliance Coordinator Combined Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX Case # XXXXXXX Final Consumer Response /* (3000, 7, 2014/01/04) */ (The consumer indicated he/she DID NOT accept the response from the business.) I still have not received a response from combined insurance regarding my claim.I called and was told I would receive a response in the mail. I still have not gotten a response. Final Business Response /* (4000, 9, 2014/01/09) */ RE: POLICY #: WXXXXXXX, CLAIM #: XXXXXXXX As stated in our December 27, 2013 response, our Claim Department would be contacting Ms. ****** directly to address her concerns. Our records indicate that Ms. ****** phoned us that same day, December 27, 2013, at which time our Customer Service Representative informed her that the matter was in review and we asked that she allow more time. On December 31, 2013, a letter was mailed to Ms. ****** informing her of our findings. We respectfully ask that Ms. ****** allow sufficient time for mailing, taking into consideration the holiday mail schedule as well as the subsequent inclement weather. If we may be of further assistance, please let us know. Sincerely, ****** L. ******* Senior Compliance Coordinator Combined Insurance Company of America Consumer Service Investigations (direct line) X-XXX-XXX-XXXX (toll free) X-XXX-XXX-XXXX Ext. XXXXX (fax) X-XXX-XXX-XXXX Case # XXXXXXX

1/10/2014 Problems with Product/Service | Read Complaint Details
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Complaint: My husband ***** used to hold an accidental death policy with Combined, When he got sick with terminal cancer I cancelled the policy. Combined calls at least once per week and asks to speak to my husband even though I have told them countless times that my husband passed away this past January. They always say ok I will note the account but then the next week they call back. It is very frustrating for a grieving widow to get these calls over and over again!

Desired Settlement: I just want them to be respectful and stop calling me.

Business Response: Initial Business Response /* (1000, 7, 2013/12/30) */ Please see attached document.

12/16/2013 Problems with Product/Service | Read Complaint Details
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Complaint: Have had policy since 3/2013 and have been paying monthly for policy. After filing a claim the company THEN requests medical records. Combined Insurance has denied my claim for benefits due to a history of a MRI. I am currently out of work due to complications in my pregnancy and unable to complete my duties as a Registered Nurse until after I deliver my child. Combined Insurance adjuster has told me that because of a previous MRI I would have had to have a rider on the policy relating to my back. Regardless, my claim has NOTHING to do with my back or a previous MRI. The claim is for my CURRENT pregnancy. A person pays for a policy for 8 months and believes they will be covered in the event they are unable to perform their job duties only to be told AFTER a claim is filed that their policy is null and void. This is completely a scam and Combined Insurance looks for ANY way to NOT pay their policy holders

Desired Settlement: I am seeking the amount of money I would have received from my claim from 10/14/13 through 2/1/13 which is the amount of time I will be disabled and unable to complete my job duties. This amount is approximately $4,095 ( monthly benefit of $1,700 and 3.5 months disabled).

Business Response: Initial Business Response /* (1000, 5, 2013/12/05) */ December 4, 2013 BETTER BUSINESS BUREAU SERVING CHICAGO & NORTHERN ILLINOIS ATTENTION: MS. ******* ****** RE: YOUR COMPLAINT CASE#: XXXXXXXX (Ref#XX-XXXXX-XXXXXXXX-X-XXX) CONSUMER: ****** ******* Dear Ms. ******* Thank you for your correspondence dated December 2, 2013, referenced above. Please be advised that we have contacted Ms. ****** ******* directly and provided a written response addressing her concerns regarding claims. In accordance with HIPAA (Health Insurance Portability and Accountability Act) regulations, we are unable to disclose Ms. *******'s claims information to you at this time. Should you have any questions or if we can be of further assistance to you, please let us know. Sincerely, ***** ***** Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX /Ext XXXXX FAX: (XXX) XXX-XXXX Our Case # XXXXXXX

11/11/2013 Problems with Product/Service | Read Complaint Details
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Complaint: I WAS ADMITTED SPENT 2 NIGHTS AND 3 DAYS-RAN EKGS CAT SCAN ON IV'S HEAVY SEDATION STRONGEST PAIN MEDS AND COMBINED DENIED MY CLAIM BECAUSE THEY USED THE THEORY I WAS ONLY ADMITTED FOR OBSERVATION AND WAS THERFORE NOT ADMITTED-OBSERVATION ONLY.I HAD SEVERE CONCUSION-BACK INJURY-TORE HUNK OUT OF RIGHT ELBOW-PAINS RUNNING DOWN MY LEFT LEG AND THEY STILL DENIED MY CLAIM-THEY SAY I WAS ONLY OBSERVED-WENT INTO ER AT 4 PM OCT.7 AND DISCHARGED OCT. 9TH @NOON AND YET THEY REFUSE TO PAY ME HOSP COVERAGE. I HAVE HAD THIS INSURANCE FOR YEARS AND PAY ALMOST 200. MONTH FOR COVERAGE AND THEY DENY ME ON THE BASIS THAT I WAS ONLY IN OBSERVATION EVEN WHEN THE NIGHT IN ER THE ATTENDING PHYSICIAN TOLD MY DAUGHTER WHO IS ALSO A DR. TO GO ON HOME BECAUSE I AM GOING TO ADMIT YOUR FATHER SO WHAT ELSE WOULD YOU CALL THIS OTHER THAN BEING ADMITTED-I DON'T CARE IF ALL HE INTENDED TO DO WAS WATCH MY SEVERITY OF HEAD BACK AND ELBOW-HE STILL PUT ME ON IVS GAVE ME ONE OF THE STRONGEST PAIN MEDS EVERY 4 TO 6 HOURS AND RAN SEVERAL EKG'S ON ME -I HAD A SWEATING ATTACK WHERE I TURNED TOTALLY WET AND THEY RAN SUGAR TESTS-EKG'S AND SEVERAL OTHER TESTS AND CONCLUDED IT WAS FROM THE SEVERE HEAD INJURY AND ON MY PAPERS THAT I SENT COMBINED I CIRCLED NUMEROUS TIMES THEY TALKED ABOUT MY ADMITTANCE AND MY DISCHARGE-COMBINED ADMITS I WAS ADMITTED BUT ONLY FOR OBSERVATION-WELL IF I WAS ADMITTED FOR HEART ATTACK AND THEY KEPT ME FOR 3 DAYS MONOTORING MY HEART -WOULD I NOT STILL BE AN ADMITTED PATIENT-IT IS A LOOP HOLE THAT COMBINED HAS FOUND TO DENY PAY FOR HOSPITAL TIME OR HOSPITAL STAY-I FELL DOWN A FLIGHT OF STAIRS AND HAD SEVERAL THINGS WRONG WITH ME AND WHILD BEING ADMITTED THEY TREATED THOSE INJURIES!!!!!

Desired Settlement: I WANT MY HOSPITAL STAY COVERED UNDER MY POLICIES AND I WANT MY DISAABILITY PAY AND ANY OTHER PAY COVERED UNDER MY POLICIES.GUSTIMATE AROUND 4000.00 DOLLARS!!!

Business Response: Initial Business Response /* (1000, 5, 2013/10/29) */ October 29, 2013 ******* ****** Better Business Bureau Your Case #: XXXXXXXX Insured: *** ******** Dear Ms. ******* This letter is being provided in response to your email of October 25, 2013. In his inquiry to your office, Mr. ******** reported that he was admitted as an inpatient for two days (possibly three) as a result of his loss. Ms. ********'s accident coverage provides inpatient hospitalization benefits if he is confined as an inpatient in a Hospital. The language of his accident coverage defines Inpatient as "Hospital confinement which the Hospital classifies as Inpatient. It does not mean confinement on an outpatient basis." In order to have a more complete understanding of his claim, our Claim Department obtained additional information from the ***** Medical Center. Our Claim Department was advised that he was treated in outpatient observation, not as an Inpatient. While we note that our Claim Department discussed this with Mr. ******** during their October 23, 2013 telephone call to him, his inquiry to your office prompted our Claim Department to contact the hospital again. On October 28, 2013, the adjustor spoke with Patient Accounts. They advised the adjustor that he was treated in outpatient observation. Since he was not admitted as an inpatient our Claim Department remains unable to provide inpatient hospital benefits under the terms of his coverage. In addition to this response to your office, we also provided a written response to Mr. ********. We trust that this letter satisfactorily responds to your inquiry. If you have any questions, or if I can be of further assistance, please let me know. Sincerely, **** ******* Senior Coordinator Combined Insurance Company of America Consumer Service Investigations Direct: (XXX) XXX-XXXX Toll Free: (XXX) XXX-XXXX / Ext XXXXX FAX: (XXX) XXX-XXXX Case # XXXXXXX

9/30/2013 Delivery Issues

Customer Review(s)

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8 Customer Reviews on Combined Insurance Company
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