To whom it may concern: I have asked for the complete comprehensive policy provided to**********************. Marilyn H***** human resource person for********************** indicated to me via e- mail that********************** does not posses the complete comprehensive policy that has the inclusions and exclusions provided within the text of the policy. I have asked for such for a month and what I have received thus far, is summary of the plan provided to the employee and their dependents and a membership certificate. These documents do NOT address the exclusion of (Attrition, defined as wear of the lower anterior teeth by years of friction from the upper anterior teeth or visa versa). Via an posterior x-ray provide to Delta Dental's Dentist, a diagnosis of Attrition was made based only on a posterior view of my lower anterior teeth. If in fact Delta Dental's dentist saw the anterior view of my lower anterior teeth by examining the patient, he or she would in fact see and note that in fact the 5 lower teeth in question were in fact fractured by blunt force trauma as the lower anterior teeth have fractures that follow multiple planes and angles consistent with fracture and NOT Attrition as Delta Dental has determined. I was initially denied coverage for (five) crowns on the anterior lower teeth. Then after reconsideration I was informed by Delta Dental verbally and then in writing that they would cover two of the five fracture teeth with crowns. In addition after my asking for, Delta Dental has refused to provide me a copy of the complete group policy in its entirety. My former employer********************** has indicated to me that they also do not have the complete policy in their possession as well. I was a health insurance agent and it is odd that my former employer does not have the complete group policy in their possession. I also have yet to receive a decision regarding my appeal after pictures of my lower anterior teeth were submitted to Delta Dental by me and my dentist which clearly show that in fact my lower anterior teeth were acutely fractured. I also find it odd that my upper teeth were fractured related to the same acute incident and Delta Dental approved veneers for my four upper anterior teeth not once but twice, yet they have denied three of the five fractured lower anterior teeth. Let it be known I have asked Delta Dental to have their dentist to examine my teeth in person. Dr Joseph B**** DDS Initially did the composite work on upper and lower fractured anterior teeth. In 1984 to 1986? Dr Mark O******* DDS placed veneers on my four upper teeth as the composite material broke off. Then in 2005 plus or minus Dr Jack W*** DMD replaced the same veneers. The lower teeth had composite applied only. Eventually the composite wore off, causing exposed soft dentin to deteriorate to the point that now I am having extreme pain due to temperature and chemical exposure to the soft dentin exposure.
This customer had a NEGATIVE experience with this business.
This customer WOULD NOT recommend the business to a friend, family member, neighbor or colleague.
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