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CNA Insurance Companies

Phone: (800) 262-1037Fax: (952) 983-5194

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Customer Complaints Summary

16 complaints closed with BBB in last 3 years | 6 closed in last 12 months
Complaint TypeTotal Closed Complaints
Billing / Collection Issues2
Problems with Product / Service14
Advertising / Sales Issues0
Delivery Issues0
Guarantee / Warranty Issues0
Total Closed Complaints16

Complaint Breakdown by Resolution

Complaint Resolution Log (16)BBB Closure Definitions
02/20/2015Billing / Collection Issues | Read Complaint Details
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Complaint
I was sent an overdue bill for longterm health insurance for a person I don't know who has named me responsible to pay this overdue premium.
CNA sent me an overdue bill for a long term health care premium frm an ************* who apparently named me as someone responsible for this payment. My concern is CNA has not kept my name and address private. I held the Power of Attorney for my parents and used to pay CNA for their premiums (which ended in 2007). My name and address were on the checks I mailed. I am alarmed that my information is being falsly used.

Desired Settlement
I want CNA to remove any information about me in their files and data base. I want them to check if there is a poicy holder with that name and number. I do not want any more bills to arrive from any of their policy holders. I'd like an apology and for this situation to be expllained and taken care of.

Business Response
February 9, 2015
****** *******, Mediation Coordinator
Better Business Bureau of Minnesota and North Dakota
220 River Ridge Circle S
Burnsville MN 55337
RE: Complainant: ***** *******
Case #: ********
Dear Ms. *******,
LTCG, the third party administrator for Continental Casualty Company ("CNA"), received your inquiry
on January 30, 2015 regarding a complaint filed by Ms. ******* concerning a billing notice she
received.
Due to federal privacy laws relating to the disclosure of protected health information (PHI), enacted
with the Health Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any
details with your agency regarding the notice sent to Ms. *******. However, CNA will respond
directly to Ms. ******* in writing regarding her concerns.
In the future, Ms. ******* is encouraged to contact CNA's Long Term Care Service Center directly at
1-800-******** for immediate assistance with any questions she may have regarding
correspondence from CNA. Our Customer Service representatives are available Monday-Friday,
8:00am to 5:00pm, Central Time.
Respectfully,
************
************, Senior Policy Owner Services Specialist
(800) ********


***Original document attached.

12/18/2014Problems with Product / Service | Read Complaint Details
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Complaint
Early July I filed a claim for long term care with CNA insurance. After over 4 months have not been able to resolve this claim. They always want more information. we started by them having to update information including a copy of my social security card because their information didn't match the info. I gave them. The info. did match the original application. From there on either they can't get the provider to respond or the provider doesn't submit the proper info. or more is needed. From day one it appears they want to wear the customer down until they give up. CNA keeps claiming the care provider doesn't understand what they are demanding or send the wrong info. Every time I call they say they have received what they need and are processing the claim or have requested more info.
Product_Or_Service: Long Term Care
Account_Number: *********

Desired Settlement
I want my claim settled.

Business Response
attached is CNA's Long Term Care response to your case # ********.

Page 1 of 1
************** St. Paul, MN 55164‐0912
December 5, 2014
****** *******, Mediation Coordinator
Better Business Bureau of Minnesota and North Dakota
220 River Ridge Circle S
Burnsville MN 55337

Re: Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Dear Ms. *******,
LTCG, the third party administrator for Continental Casualty Company (“CNA”) received your inquiry
on December 2, 2014 regarding a complaint (BBB Case # ********) filed by *** ******* concerning
her long term care claim. As Lead Care Manager, I have been asked to respond.
The insured owns a Long Term Care policy purchased in the state of Pennsylvania. Due to federal
privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health
Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your
agency regarding the insured™s policy or claim file.
All of our policyholders are advised of their option to contact CNA directly with questions or concerns
related to their Long Term Care policy coverage. Policyholders may also contact their state™s
Department of Insurance regarding any concerns they may have regarding their policies or claims.
Please be advised that CNA approved Ms. *******™s claim and advised Mr. ******* *******, an
authorized individual on the policy, of the benefit determination via telephone on December 3, 2014.
A detailed letter to the insured was also mailed on December 4, 2014 regarding her claim.

Respectfully,
*************************, LCSW
Lead Care Manager
(800) ********

Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
We recieved a call and a letter saying the claim was approved. we did recieve a check for July. The letter inform us that they were waiting for more information. I was told that they have riecieved the requested information, but nothing since. We havn't had the time to follow up due to other medical necessities. but will shortly if we don't recieve something soon

09/30/2014Problems with Product / Service | Read Complaint Details
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Complaint
CNA has not been responsive to my attempts to start a claim for my mother.
My mother has been paying in for 18 years on policy *********. I attempted to open a claim on Aug. 6, 2014. After trying to call me on Sept.3 and 4, ***** closed the claim. I attempted to return her call on the 3rd, and gave up after 6 minutes on hold. I attempted to return her call at 3 p.m. Pacific Time on the 4th but you were closed. I called today to be told that I had to start over and that I could not directly reach an intake person, as they call when it is convenient for them. I work and am not available at every moment. Today I spoke with two people before talking with ********, a supervisor. She stated that I could not speak with an intake person by being transferred immediately as that's "not how the process works." She did attempt to schedule for a time frame on Monday or Tuesday for an intake person to call me. I spent over half an hour on the phone today trying to get action and I got nothing tangible. After a month of effort, the claim still isn't even open, much less fulfilling the contract. It appears that your process is intended to delay starting claims or fulfilling the contract. The first person to whom I spoke today refused to talk to me because you have the wrong phone number for my mother and at that moment I did not have her social security number. My mother moved 3 1/2 years ago and you changed her address but kept the old phone number with an error in one of the digits.

Desired Settlement
I want some decent customer service--like being able to call in when it is convenient for me--and for the contract to be fulfilled without your company continuing to make it as difficult as possible. I estimate my mother has paid in between $60 and $80k. It is also interesting to me that just after I attempted to open a claim, her premium went up 20%.

Business Response
Attached is response

Re: Policy No.: *********

Underwriting Co.: ****************************

BBB Case #: ********

Dear Ms. *******,

Long Term Care Group, Inc. (LTCG), the third party administrator for **************************** ("CNA") received your inquiry on September 8, 2014 regarding a complaint (BBB Case # ********) filed by ***** **** concerning her mother's long term care claim. As Lead Care Manager, I have been asked to respond.
The insured owns a Long Term Care policy purchased in the state of California. Due to federal privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your agency regarding the insured's policy or claim file.
All of our policyholders are advised of their option to contact CNA directly with questions or concerns related to their Long Term Care policy coverage. Policyholders may also contact their state's Department of Insurance regarding any concerns they may have regarding their policies or claims.
Please be advised that CNA spoke directly with Ms. **** on September 12, 2014 regarding her concerns and a claim was opened under the insured's policy. A detailed letter to the insured was also mailed on this date that explains the claim review process and outlines the actions that CNA has undertaken in order to finalize a benefit eligibility determination.

Respectfully,

************************, LCSW
************************, LCSW Lead Care Manager (800) ********


06/30/2014Problems with Product / Service | Read Complaint Details
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Complaint
WILL NOT PROCESS CLAIMS WITHOUT FIRST TRYING NOT TO PAY.
I have found this company to be the worst in dealing with LONG TERM CARE CLAIMS!!
They are the worst company, with the worst customer service I have ever seen. However, it is so sad that the customer and the family have to go thru enough when something happens, little on do not receive the help they need. THESE PEOPLE PAY OUT THE MONEY, AND GET NOTHING IN RETURN. THE COMPANY TRIES ITS BEST TO FIND WAYS NOT TO PAY CLAIMS. We started asking for help in March of 2013, and sadly my mother in law passed away in November 2013, and here it is June 2014, and we still are having trouble getting them take care of claims. I really wished this company would have to pay back all money they collected over the years plus interest to the family's that have to go thru this. Then maybe they would be come a better company.

Desired Settlement
AT THIS POINT, WITH ALL THE CALLS, REFAX'S, NEVER GETTING TO TALK TO THE SAME PERSON, OR PERSON HIGHER UP, AND THE PAIN AND STRESS THIS CAUSE THE POLICY HOLDER.........WHICH HAS PASSED AWAY....AND HER FAMILY, I WOULD SAY A COMPLETE REFUND/THANK YOU.

Business Response
June 11, 2014


Better Business Bureau of Minnesota and North Dakota
220 S River Ridge Circle
Burnsville MN 55337

RE: Continental Casualty Company

Dear Sir/Madam,

Continental Casualty Company ("CCC") received your inquiry on June 5, 2014 regarding a complaint (BBB Case #********) filed by ****** ******* concerning her late mother's long term care claim. As Lead Care Manager for Long Term Care Group, Inc. (LTCG), a third party administrator for CCC, I have been asked to respond.

Please be advised that due to federal privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your agency regarding any insured's policy or claim file. However, CCC will respond directly to Ms. ******* in writing regarding her concerns.

All of our policyholders and their representatives are advised of their option to contact CCC directly with questions or concerns related to their Long Term Care policy coverage. Policyholders and representatives may also contact their state's Department of Insurance regarding any concerns they may have regarding their policies or claims.

In the future, Ms. ******* is encouraged to contact CCC's Long Term Care Service Center directly at 1-800-******** for immediate assistance with any questions she may have regarding the insured's policy. Our Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm, Central Time.

Sincerely,

************************, LCSW

************************, LCSW
Lead Care Manager
(800) ********

02/24/2014Problems with Product / Service | Read Complaint Details
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Complaint
My mother is in a nursing home;the red tape involved in restarting her payments has been ongoing for 100 days.
Long term care payments need to be reinstated at mother's nursing home, and each phone call requests new and different information. The info has been provided and still no check has been issued. Nov. 4, 2013 was the day she moved. Contact was made initally on Oct. 31, 2013. Despite several phone calls that assured me that the claim was being reviewed, I found on on Dec. 17, that the needed materials had not been sent. Another 45 day waiting period insued and on Feb. 3, 2014, I am told the policy still had not been reviewed, but that all documents were in place. On Feb. 7, I was told that we had not submitted the needed invoices. On Feb.10, I was told different documents were needed. All calls have been initiated by me. No one from CNA has ever bothered to contact me or the nursing home to request specific materials.
Everyone is very nice and polite and offers help, but nothing happens. It is gross negligence on the part of CNA. The insurance was paid for in good faith and should be returned by the company.

Desired Settlement
I want the payments for Nov., Dec., Jan. plus continuing through my mother's life or the contract paid. If this continues, I will ask for interest and punitive payments.

Business Response
February 19, 2014

***** *****
Better Business Bureau of Minnesota and North Dakota
220 S. River Ridge Circle
Burnsville, MN 55337

Re: Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Dear Ms. *****:

Continental Casualty Company ("CCC") received your inquiry on February 10, 2014 regarding a
complaint (BBB Case #********) filed by ****** ******** concerning her mother's long term
care claim. As Lead Care Manager for Long Term Care Group, Inc. d/b/a Univita, a third party
administrator for CCC, I have been asked to respond.
Please be advised that due to federal privacy laws relating to the disclosure of protected health
information (PHI), enacted with the Health Insurance Portability and Accountability Act (HIPAA),
we are unable to disclose any details with your agency regarding any insured's policy or claim
file.
We contacted Ms. ******** and spoke to her regarding her complaint. She stated that she had
spoken with someone from our office earlier this week, and that her concerns were resolved.
Ms. ******** is encouraged to contact CCC's Long Term Care Service Center directly at *************** for immediate assistance with any questions she may have regarding the insured's
policy. Our Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm,
Central Time.

Sincerely,
************************, LCSW
************************, LCSW
Lead Care Manager
Long Term Care Claims

Page 1 of 3
06/11/2014Problems with Product / Service | Read Complaint Details
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Complaint
Withholding or failing to make timely long term care benefit payments pursuant to long term care contract with ************, account *********.
The insured, ***************, account #*********, has a long term care policy with CNA. This policy has been in place for several years. Despite repeated and numerous attempts by telephone calls placed to the company, there has been continued and repeated withholding of and or delay in processing long term care benefit payments despite having all necessary information provided to company. My name is ************* and I have power of attorney on the account and full authorization to act on behalf of the insured who is 89 years old.

Desired Settlement
Company must make all benefit payments due up to date of submitted documentation and continue to make payments in a timely manner for the length of the contract term.

Business Response
May 21, 2014

***** *****
Better Business Bureau of Minnesota and North Dakota
220 S. River Ridge Circle
Burnsville, MN 55337

Re: Underwriting Co.: ****************************
Policyholder Name: ******* *******
BBB Case #: ********

Dear Ms. *****:
Long Term Care Group, Inc. d/b/a Univita, the third party administrator for **************************** ("CCC") received your correspondence dated May 5, 2014. I have been asked to respond.
Ms. ******* owns a Long Term Care policy purchased in the state of New York. Due to federal
privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health
Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your
agency regarding Ms. *******'s policy or claim file. However, on May 14, 2014, CCC did provide a
written response to Mr. ******* regarding the review and status of Ms. *******'s claim.
All of our policyholders are advised of their option to contact CCC directly with questions or concerns
related to their Long Term Care policy coverage. Policyholders may also contact their state's
Department of Insurance regarding any concerns they may have regarding their policies or claims.
In the future, Mr. ******* is encouraged to contact CCC's Long Term Care Service Center directly at
1-800-******** for immediate assistance with any questions he may have regarding the insured's
policy. Our Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm,
Central Time.

Respectfully,
*******************
*******************, Supervisor
Claims Exam
(800) ********

Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
I received correspondence from CNA on May 21, 2014. The letter acknowledges that "there has been some delay in claims processing resulting in delayed benefit payments". The delay in payments continues. I submit bills once a week and CNA states there is a turnaround time of 10 business days which is unconscionable considering the premiums that were paid on this policy. We have received no further payments for 2 weeks.

04/17/2014Problems with Product / Service | Read Complaint Details
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Complaint
We filed a claim on 10/15/13. Despite complying with every request for information, we are still waiting to find out if our claim will be approved.
My mother,******************, is 74 years old and has advanced Parkinson's disease which will require ongoing assistance with activities of daily living for the remainder of her life. She has paid premiums on a long term care policy with Continental Casualty Company for approximately 13 years. We have been attempting to get a claim approved by the insurance company since October 15th of last year. After jumping through many hoops, we were told on February 3rd that they had received all of the required information and that our claim would be finalized within 10 business days. However, today I was informed that another request for additional information has been sent to my mother, and that it could take 30 more days before we receive an answer about whether her claim has been approved. It should NOT take 5 months to process a claim. Meanwhile my mother's well being, and my peace of mind hang in the balance.

Desired Settlement
We would like to have my mother's long term care insurance premium waived according to the terms of her insurance policy. We would also like to know if my mother's claim has been approved so that we can move forward with coordinating additional care through Visiting Angels.

Business Response
February 21, 2014

Re: Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Long Term Care Group, Inc. d/b/a Univita, the third party administrator for Continental Casualty
Company ("CNA") received your correspondence dated February 11, 2014. I have been asked to
respond.
Ms. ******** owns a Long Term Care policy purchased in the state of Florida. Due to federal
privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health
Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your
agency regarding Ms. ********'s policy or claim file. However, on February 21, 2014, CNA did
provide a letter to Ms. ******** regarding the review and status of her claim.
All of our policyholders are advised of their option to contact CNA directly with questions or concerns
related to their Long Term Care policy coverage. Policyholders may also contact their state's
Department of Insurance regarding any concerns they may have regarding their policies or claims.
In the future, Ms. ****** is encouraged to contact CNA's Long Term Care Service Center directly at
1-800-******** for immediate assistance with any questions she may have regarding the insured's
policy. Our Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm,
Central Time.

Respectfully,
*************, LAPSW
*************, LAPSW
Senior Care Manager
(800) ********

Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
The insurance company claims that they cannot disclose any details regarding my mother's claim due to federal privacy laws. However, this is not true. The Privacy Rule standards address the use and disclosure of individuals' health information--called "protected health information" by organizations subject to the Privacy Rule -- called "covered entities." A covered entity may use and disclose protected health information for its own treatment, payment, and health care operations activities. A covered entity also may disclose protected health information for the health care operations of another covered entity involving either quality or competency assurance activities or fraud and abuse detection and compliance activities, if both covered entities have or had a relationship with the individual and the protected health information pertains to the relationship. Health care operations are any of the following activities: conducting or arranging for medical reviews, audits, or legal services, including fraud and abuse detection and compliance programs. http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html

The insurance company is attempting to use patient privacy as a shield to protect them from review by the BBB. The reply they provided is a "canned" response that is designed to make it appear as though they are powerless to address the BBB complaint. Patient privacy is not an issue in this case. However, if the insurance company was truly concerned about patient privacy, then they could easily obtain my mother's consent to discuss this case with the BBB, and that would absolve them of any concerns about violating patient privacy. The company's claim that they cannot address the claimant's concerns because of privacy laws is bogus. If the BBB accepts their flawed rationale, then the BBB is complicit in allowing this company to continue it substandard business practices.


Final Business Response
March 11, 2014

***** *****
Better Business Bureau of Minnesota and North Dakota
220 S. River Ridge Circle
Burnsville, MN 55337

Re: Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Dear Ms. *****:
Long Term Care Group, Inc. d/b/a Univita, the third party administrator for Continental Casualty Company
("CNA") received your correspondence dated February 27, 2014. I have been asked to respond.
Due to federal privacy laws relating to the disclosure of protected health information (PHI), enacted with the
Health Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your
agency regarding Ms. ********'s policy or claim file without a signed authorization from Ms. ******** or her
legal representative. The authorization submitted by your office is signed by ***** ******. However, we have
no documentation designating Ms. ****** as the legally authorized representative of Ms. ******** with the
authority to make such a request.
CNA has received an Authorization for Use and Disclosures of Protected Health Information form signed by
Ms. ******** which allows us to disclose protected health information (PHI) to Ms. ******. However, this
form does not authorize Ms. ****** to make decisions regarding Ms. ********'s legal, business or financial
affairs, which would include insurance related matters under her Long Term Care policy and the release of her
PHI to another entity.
On March 4, 2014, CNA did provide a letter to Ms. ****** regarding the review and status of Ms. ********'s
claim.
In the future, Ms. ****** is encouraged to contact CNA's Long Term Care Service Center directly at 1-800-
******** for immediate assistance with any questions she may have regarding the insured's policy. Our
Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm, Central Time.

Respectfully,
*************, LAPSW
Senior Care Manager
(800) ********

Final Consumer Response
Attached is the signed form that you requested.


Business Response
April 7, 2014

***** *****
Better Business Bureau of Minnesota and North Dakota
220 S. River Ridge Circle
Burnsville, MN 55337

Re: Insured: *****************
Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Dear Ms. *****:

Continental Casualty Company ("CCC") received the follow up inquiry you submitted on March 17,
2014 regarding BBB Case #********. As Lead Care Manager for Long Term Care Group, Inc. d/b/a
Univita, a third party administrator for CCC, I have been asked to respond.
CCC has reviewed the document submitted by ***** ****** requesting that CCC release information
regarding the insured's policy and claims to the BBB. CCC has determined that this document does
not constitute an authorization compliant with federal privacy laws (HIPAA) and is unable to accept it.
Please be advised that CCC has already addressed Ms. ******'s complaints in a detailed written
response directed to the Florida Department of Insurance (file number 1-*********) on March 27,
2014.
Further, CCC has approved all claims submitted under the insured's policy and our claims examiners
are currently processing the claims per the policy schedule. A detailed letter advising the insured of
the approval of her claim was mailed to her on March 27, 2014.

Respectfully,
************************, LCSW
************************, LCSW
Lead Care Manager
(800) ********


Consumer Response
(The consumer indicated he/she DID NOT accept the response from the business.)
As soon as I was advised by CCC that the form we initially submitted was not authorization compliant, we submitted the correct form to the BBB. Perhaps the BBB did not forward that form on to CCC.

At any rate, from reading the other BBB complaints against CCC, it is painfully obvious that CCC has an ongoing pattern of delayed claims processing. Whenever a client registers a complaint against CCC, their initial modus operandi is to hide behind a false claim that they cannot respond to the BBB because of patient confidentiality. That is simply not true, so CCC should not be allowed to use this stall tactic. Instead, they should immediately offer the appropriate form which allows the client to authorize the release of any pertinent information to address the complaint.

While CCC has finally processed her claim, the marked delay resulted in my mother having to pay for covered services out of her own pocket for several months while she was waiting for CCC to complete her claim. While CCC admitted that this should not have happened, that did not change the fact that my Mom suffered from significant inconvenience and was also saddled with additional expenses that would have otherwise been covered by CCC if her claim had been processed in a timely manner.

While a waiver of premium has finally been processed, we are still waiting for CCC to reimburse my Mom for her Meals on Wheels expenses. I was told on 3-13-14 during a recorded telephone conversation with CCC that these expenses were covered and would be reimbursed. Almost a month has gone by, and my mother is still waiting to receive her check.

CCC is notorious for dragging their feet when it comes to processing and paying out claims. This is unacceptable. CCC's lack of customer satisfactions is reflected in its poor BBB rating which serves as a much needed warning for other consumers.

01/31/2013Problems with Product / Service | Read Complaint Details
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Complaint
Ruth Marie Harrison - 077066731

Claim for assisted living. The diagnosis of dementia is ongoing severe cognitive impairment for my mother
Ruth Marie Harris Long Term Health Care Policy 077066731
Represented by son with POA for health care and property: Gary L. Harris in Frankfurt, Germany

Several times on the phone, CNA staff was not informed of ongoing correspondence or documents already sent to them by care providers including the admissions assessment of the assisted living facility. Ridiculously, they cited an earlier cognitive testing of no impairment although that testing was outdated and documented by the attending physician via diagnosis of dementia. I was told that they wanted a new testing and would pay for it but recieved no further word as to this happening.

In a letter from Oct 15, 2012, I was informed that they cannot process the claim due to lack of information. three days later I recieved a letter dated Oct 18 that the claim is not approved.

Instead of CNA collecting the information with my signed waiver of information rights, they seem not to have collected the information they said they desired. Chronically ill includes my mother's inability to carry out certina daily functions but most of all it includes severe cognitive impairment which is documented by her doctor via diagnosis of dementia.

Family is constantly looking in on my mother because of cognitive impairement and I Gary Harris son with POA for health care and property must regulary monitor my mother's activities from Germany while other family and paid private help for shopping, washing hair, etc. are organized and paid for by me out of the pocket.

Dementia is severe cognitive impairment and the fact remains that my mother has dementia as an ongoing every day severe cognitive impairment. All nursing staff recommended assisted living or a nursing home. The assisted living facility sent their assessment twice to CNA because I was informed by a staff member that they did not have this documentation. The staff was frequently not informed as to correspondence and the company seemed to try to think up something new each time to create as many hurdles as possible.

It boils down to dementia as the one clear fact of severe cognitive impairment that no one can dispute. If CNA will not accept the legal validity of a doctor's diagnosis, then it is CNA who must prove that my mother Ruth Marie Harrison does not have severe cognitive impairment due to dementia.

Kind regards,

Gary L. Harris
Paul-Bode-Str. 6
60433 Frankfurt
Germany
Email: gary.harris@gmx.de

Gary L. Harris US Residence:
Paul-Bode-Strasse 6 1006 West Cherry St.
60433 Frankfurt Marion, IL 62959
Germany USA

Email: gary.harris@gmx.de
Phone: 01149 69 515021
Fax: 01149 69 53059623

Son & Agent with Power of Attorney for Property (all financial and legal matters)
for: Ruth Marie Harrison 1006 W Cherry St. Marion, IL 62959



Desired Settlement
Approval of claim,
ending of run around tactics, and
proof that my mother has not been cured from her severe cognitive impairment illness of dementia since the time it was diagnosed by her attending physician Dr. Josephs in Marion, Illinois.

Business' Initial Response
December 11, 2012

***** *****
Better Business Bureau of Minnesota and North Dakota
220 S. River Ridge Circle
Burnsville, MN 55337

Re: Insured: *******************
Policy No.: *********
Underwriting Co.: Continental Casualty Company
BBB Case #: ********

Dear Ms. *****:

Continental Casualty Company ("CCC") received an inquiry dated December 6, 2012 regarding a complaint (BBB Case #********) filed by******** ****** concerning a claim filed under the above referenced Long Term Care policy issued to ****************. As a Senior Care Manager for Long Term Care Group Inc., a third party administrator for CCC, I have been asked to respond.

Ms. ******** owns a Long Term Care policy purchased in the state of Illinois. Due to federal privacy laws relating to the disclosure of protected health information (PHI), enacted with the Health Insurance Portability and Accountability Act (HIPAA), we are unable to disclose any details with your agency regarding Ms. ********'s policy or claim file.

If Mr. ****** feels that the information CCC received is incorrect or incomplete, he may request a review of this denial by writing CNA Insurance Companies. Mr. ****** should state the reason he feels Ms. ********'s claim should not have been denied and submit additional documentation to support his position. Mr. ****** may forward his request for a reconsideration of the denial to the following address:

CNA Claims Administration
Attention: Claims Manager
**************
St. Paul, MN 55164-0912

In the future, Mr. ****** is encouraged to contact CCC's Long Term Care Service Center directly at ************** for immediate assistance with any questions he may have regarding Ms. ********'s policy. Our Customer Service representatives are available Monday-Friday, 8:00am to 5:00pm, Central Time.

Sincerely,

*************, LAPSW
Senior Care Manager
Long Term Care Claims

Consumer's Final Response
(The consumer indicated he/she DID NOT accept the response from the business.)
The June 28 Plan of Care provided by the attending physician clearly states that more than two daily activities cannot be carried out by the patient without assistance and in part total dependence on assistance is the case at hand.

These include:
- Meal preparation
- Taking medication properly
(either forgetting to take medication or taking medication incorrectly)
- Housekeeping
- Bathing
- Going shopping
- Doing laundry

The attending physician also clearly states that the patient and long term health care policy holder has dementia and it is clear from the activities listed that severity of cognitive impairment requires assistance.

Regarding test results:
A representative of CNA told the complainant on the phone in Nov. 2012, that in absence of current testing since the diagnosis of the attending physician, that they would contact the local health care (skilled nursing service) to organize an up-to-date cognitive testing. This has not happened.

All documents that CAN sent to the complainant for filing were filled out by the respective service providers and attending physician. If CNA will not accept the diagnosis and evaluation of the attending physician regarding daily care needs as well as dementia that leads to the necessity of daily care and supervision, then they must organize testing to disprove the diagnosis and evaluation of the physician. Until that time, the severe cognitive impairment that is endangering the patient and policy holder is the most current and most qualified proof for approval of claim.

Without the private out of the pocket paid care and other non-paid supervision and care that the policy holder is now receiving and constantly supervised and monitored by her son and agent with POA for Health Care and Property, the patient and policy holder would not be able to continue being at home and in spite of ongoing assistance is unnecessarily endangered as long as she is at home.

Kind regards,

Business' Final Response
business response is attached

03/13/2013Problems with Product / Service

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Insurance Companies

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BBB Business Reviews are provided solely to assist you in exercising your own best judgment. Information in this BBB Business Review is believed reliable but not guaranteed as to accuracy.

BBB Business Reviews generally cover a three-year reporting period. BBB Business Reviews are subject to change at any time.

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What is a BBB Business Review?

We offer free reviews on businesses that include background, licensing, consumer experience and other information such as governmental actions that is known to BBB. These reviews are provided for businesses that are BBB accredited and also for businesses that are not BBB accredited.

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BBB Reporting Policy

As a matter of policy, BBB does not endorse any product, service or business.

BBB Business Reviews are provided solely to assist you in exercising your own best judgment. Information in this BBB Business Review is believed reliable but not guaranteed as to accuracy.

BBB Business Reviews generally cover a three-year reporting period. BBB Business Reviews are subject to change at any time.