ComplaintsforActive Care Management

• Initial Complaint

  11/07/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I submitted a dental claim to this company, called prior to treatment, submitted all required documents. The total coverage on the policy is $300, there is a $500 deductible, total for this one claim was $1,534.19. After numerous phone calls, several months of waiting, they sent me a letter stating that $300 was applied toward my deductible, leaving a balance of $200. The next sentence was that the $1,234.19 is not payable as dental benefit limit has been reached. They should have applied the total amount for this claim, $1,534.19 toward the $500 deductible, which would leave a balance of $1,034.19. Then they should have paid me the total amount of coverage $300 from this amount. I can send you a copy of their letter if required. This is the wording from the policy that I purchased. Expenses for emergency dental treatment – • If you need emergency dental treatment, we will pay up to $300 for the relief of dental pain.

  Customer response

  27/07/2023

  The company has reached out to me after I filed this complaint. It took me several more phone calls but I have now been paid the $300 that they should have paid me several months ago. Thank you very much for your assistance.

• Initial Complaint

  05/04/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  I purchased BCAA travel insurance (who are underwriters for ACM) in Dec 2022. I made a claim for my wife (*******) on December 16,2022. BCAA/ACM advertises that claims will be processed in 8-10 weeks. It has currently been almost 4 months and my claim has neither been approved nor denied. I have made 9 phone calls over the past 2 months and have been told a manager would contact me (several times) and that my case has been prioritized as “high priority.” To date no one has ever contacted me. I have been reassured over and over again that all my documents are submitted and correct. When I speak to agents on the phone they can’t understand why my case isn’t being worked on. No one is able to provide me with correct information and no one is contacting me. I want a manager to call me and help me settle this outstanding case.

  Business response

  26/04/2023

  ****************Good day,
  
  Due to confidentiality constraints, I will not be able to provide specific and personal details regarding the claim. I can confirm that the claim has been paid out and settled as per the policy terms and conditions. The customer has cashed in their money on April 24th, 2023.
  Should the customer wish to discuss further or would require clarification, we would invite them to contact ****** ***** ********** ******** ** ************ or by email at *********************
  
  Please do not hesitate to contact us should you have any questions.
  

   

  Kind regards,

   

  ******* ********* - Customer Relations Officer

  Global Excel Management Inc.

  Customer response

  27/04/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 
  

  Sadly, settling this case took well over 4 months and 15 telephone calls to complete. And, the customer service was TERRIBLE.

  Sincerely,
  
  ***** ******

• Initial Complaint

  14/09/2022

  Complaint Type:

  Customer Service Issues

  Status:

  Unanswered

  More info

  Regarding the refusal letter dated July 15, 2022 against my claim in connection with ACM Case number ****** of the Policy number VTP-******** dated 2022-01-28 and review application dated 18th July 2022 for reviewing the denial decision on the ACM Case Number ******. On 14th April I had Glaucoma surgery on a medical emergency. But in March in an acute stage I was compelled to take admission with Emergency of Vancouver General Hospital and later on referred to the Eye Care Center. There was no choice other than valve implantation Surgery to save my eye and minimum vision. On the day 28th January 2022 I purchased the Health Insurance Policy. On 9th March 2022 I felt difficulties with my eye. I called at the call center, and an agent provided me the case number ****** obtained verbal pre-authorization. The agent advised me to check with Northeast Urgent and Primary Care Center for my initial service. I visited NUPCC on 10th March 2022. After waiting for 10 days I went to the same clinic and the clinic suggested to call and visit the eye center of Vancouver General Hospital immediately. On 24th March I was admitted in the emergency of VGH (copy attached as enclosure 2). Understanding my eye condition Emergency department called the ophthalmologist urgently. After a comprehensive investigation they referred me urgently-next morning to the eye care center. I don't have with me each clinical report of onward follow ups at eye care center (other than Dr Gill's note of 21st April'22 attached as enclosure 3) Dr Gill and his office sent a fax to your the insurance notifying the requirement of my surgery and treatment and estimated expenses Copy is attached as Enclosure 4. On 15th July I received letter from Insurance company with denial decision against my claim (copy enclosed) On 18th July after receiving in connection with all above I have submitting my formal appeal against your refusal letter (copy enclosed) Till today I have not receive claim.

• Initial Complaint

  05/07/2022

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  I purchased a flight insurance "Manulife" for flight cancelation. I had a problem with my pregnancy and was told not to travel. This fell under the medical reason for not being able to travel. I started a claim August of 2019. They stated that I qualify for the claim and to fill out the form. I filled it out and included a letter from my OB doctor. No one replied for months, I called and called finally they said they need the airline to fill out a form and contact them directly, I had to get through to the airline who then told me to fill up a form on their website, I did. They said they would contact Active Care in 6 months and they did. The claims did not contact me so iam waiting for my refund patiently for many months. Emailed them called them, finally got a hold and they said they need the doctor to now fill the form part as well even though they have the letter from the OB doctor. As frustrated as I got I contacted my OB dropped off the forms and had them fill it, (costing me an other $20, on top of the letter) The office faxed it over to Claims department. No once contacted me. I emailed and called, lady said that persons email no longer works, confirmed they got the fax and everything is in order I should get the refund in the mail in sometime. No refund no email. Called again same thing was said. Waited, nothing, its now july 2022. This has been going back and forth for 3 years. I called today lady named Shannon. S. rudest lady as if i did something bad to them claimed that they did not get he physicians letter or form! Lie as it was all faxed and confirmed two different times. I tried to explain to her but she would not listen. I said if I find proof that this was all sent would you apologize on the behalf of the company for the run around, she says no! I cannot believe this rudeness after everything! found the proof sent it in the email now still waiting for my refund and response. Worst experience ever!!! never dealing with this company or Manulife ever

• Initial Complaint

  13/06/2022

  Complaint Type:

  Service or Repair Issues

  Status:

  Unanswered

  More info

  Dec 3, 2021 - I was brought to ********************* for treatment due to accident. I have coverage with Manulife (policy #*************). At the onset, *********************************** communicated with Manulife and filed a claim (claim #*******). Since Feb 28, together with my advisor, we constantly communicated with Manulife regarding the status of the claim and what else is required from me. Manulife ACM have been repeatedly telling me and my Advisor that I have completed all requirements and claim request is on process. My advisor was also told that turn-around time is 4 to 6 weeks (but as of June 11, the turn-around time was increased to 8 to 10 weeks). Claims submitted to them have been more than 15-20 weeks. Medical Providers such as *****************, and the Doctor's office have been sending billings and phoning me every week to follow-up and asking for payment commitment date. Last Feb 21, 2022, I received a warning letter from Covenant Health that if I don't settle the bill within 10 business days, I will be referred to collection agency. These circumstances were made known to Manulife through my Advisor but Manulife's responses were limited to "on process".

• Initial Complaint

  24/05/2022

  Complaint Type:

  Product Issues

  Status:

  Resolved

  More info

  We bought Costco/Manulife Travel insurance and had to use the trip cancellation insurance. It was a simple claim for the cost of accommodations only, with a doctor's note and all the paperwork in order. I submitted a claim in January 2022. I followed up with the company (ACM Travel) that manages the claims and my online account was deleted around mid-Feb. I called them, I created a new account, re-submitted, etc. They said it was a 3-4 week wait due to high (covid-related) volumes and the clock might reset from the 2nd filing of the claim. They could not connect me to an IT department to rescue my first claim. I have called them in March, April, and May. In March they told me the original claim was never lost. Each time they say everything is in order, the paperwork looks good and then that a manager will call me back in 3-5 business and one never does. Well, one did some time in April and left a message saying they are processing our claim and it would be attended to within 7 days. Nothing ever happened. I called again May 4th and they said they would 'escalate it' to a complaint. I called again May 16th and again they said someone would call me within 3-5 business days. I have been on hold for 45-60+ minutes every time I call this company and they never allow me to talk to a manager. I am beginning to believe this is an industry tactic to avoid paying our claim. It has been 4.5 months since I filed the first paperwork. One of the representatives tells me this is NOT a normal timeline, even in the context of Covid delays. Yet, they are unable to help me except to "escalate" my file to nowhere. We want our claim paid out.

  Business response

  09/06/2022

  Consumer Response /* (2000, 9, 2022/06/08) */ I approached the company via tagging the go-between (Manulife) on social media and emailing the broker that originally sold me the insurance. They emailed me once and called me once (I was not able to answer) and have started to issue payment. They paid a portion of the claim and after several hours on hold I have learned that they intend to pay the remaining portion of the claim perhaps in the next 2 weeks. I think BBB can hold off on further pursuing this as it seems that my advocacy through other channels has born fruit. Thank you for your efforts to date.

• Initial Complaint

  02/05/2022

  Complaint Type:

  Delivery Issues

  Status:

  Unanswered

  More info

  I paid for travel insurance on a $ 18,900 ski trip which I had to cancel when I sustained a leg fracture. I submitted all documents and the claim has been in process for 5 months without any resolution. I am unable to contact the business by phone or email inquiry though I try every week to do so. One time I got through to a phone operator and asked to speak to a supervisor. I was told to expect a call in 3-5 business days but the company failed to contact me - they never tried. ManuLife sold me the insurance and they delegate the claims to this firm. They cannot seem to help.

• Initial Complaint

  30/03/2022

  Complaint Type:

  Delivery Issues

  Status:

  Answered

  More info

  Purchased travel cancellation insurance at time of flight booking Jan 17th, this insurance was advertised as Any Reason cancellation. Put the claim in Jan 20. Reached out by e-mail several times, checked online only to see no movement on the claim status. Called, spent an hour holding with no one available to talk to. Others have apparently had the same issues in having their claims filled.

  Business response

  09/06/2022

  Consumer Response /* (3000, 16, 2022/04/26) */ Hi, I received a notice from the company that they will not cover my claim. unfortunately that is not the result we wanted but nonetheless it was communication either way. thanks for your help.

• Initial Complaint

  31/01/2022

  Complaint Type:

  Product Issues

  Status:

  Unanswered

  More info

  - July 27, 2021: Car rented at ********* Car & Truck Rentals using ******** **** ******** Credit card - July 29, 2021: Car returned to ********* & they said there was minor damage to the car. ********* charged us $500 damage deposit and an additional $936.87 to cover repair costs (Total $1436.87). - Aug 4, 2021: I contacted ******** **** who transferred us to the Insurance department (Active Care Management - ACM); at the time, they indicated that we will need to submit a claim form with various documents which would be sent to us. Given claim number ******* - Aug 6, 2021: I called ACM as we did not receive the forms mentioned on Aug 4; the representative indicated that we do NOT need to submit claim forms, our claim is in process & that we will be contacted for any followup. - August 26, 2021: We were copied on an email sent to ****************************** from ***** *********, Claims Manager at ********* with documents regarding the car damage claim - Nov 2, 2021: I contacted ACM who indicated that our claim review was pending. They asked me to resend our claims information/documents sent by ********* by email (which I did the same day) - Nov 16, Nov 22, and Dec 3: I contacted ACM on these days & each time I was told that our claim was under review & that we will be notified of any information needed or decision made. On Dec 3, I asked for a Supervisor or Manager to contact me to discuss our claim. - Dec 6, 2021: I received an email from ***** ****** of ACM that said he has expedited our case - Dec 21, 2021: I called ACM & spoke with ********* who indicated that our file was assigned a new claims number (*******) & that our claim was being worked on - Dec 22, 2021: I received from **** ****** of ACM indicating that claim is missing some info however no forms were provided; asked for forms by email - Jan 3, 2022: I received an email from ACM indicating that we needed to complete various forms & submit electronically; forms submitted Jan 12, 2022

• Initial Complaint

  13/01/2022

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I purchased travel insurance for my father on sept 20, 2021 (see attached). Unfortunately, he developed fever, cough and was diagnosed with pneumonia (respiratory infection). I called the insurer to let them know as required by the policy. Blood work, x-ray, consultation with professionals, prescription with antibiotics help my father. On Oct 27, I submitted a claim for reimbursement (see email acknowledging the claim) to Active Care Management using the online system. As you can imagine this is a relatively small claim (less than 800 CAD). I called them three times (End of Nov 2021, Dec 14, and Jan 6) as there was no news regarding the reimbursement. The answer was always the same: wait or "will send an internal memo to expedite the process". On Jan 6, I was tired of excuses and a lack of resolution. I requested to speak with the manager at Active Care Management. *** (customer service) told me the manager was not on-site and would call me. I provided my cell phone. I have not yet received a phone call. I have not yet received any further communication about the reimbursement. My broker also called on Jan 10 and Jan 11 to Active Care Management and got the same answers. I was diligent to pay for the travel insurance, to alert about the health status of my father and to submit the claim. I expect a prompt reimbursement and resolution of this matters. Customers are not expected to have to follow-up multiple times for a legitimate and relatively small reinburment. What would be expected for larger claims or other senior people who may have difficulty to follow up, submit claims etc?.

  Business response

  01/03/2022

  Business Response /* (1000, 9, 2022/01/31) */ To whom it may concern, The claimant has followed the complaint resolution process and the claim has been settled on 1/20/22. The claimant was contacted and made aware of this on the same date. Consumer Response /* (3000, 11, 2022/01/31) */ (The consumer indicated he/she DID NOT accept the response from the business.) This claim has NOT been settled. As stated, the Active Care Management (ACM) company does not take responsibility. I requested a reimbursement for the CAD 733.83 paid to ACM since they provided NO care to my father, made no follow up calls to know his health status or facilitated any studies or appointments. Furthermore, ACM did not provided prompt process of the claim. As explained to them by e-mail and then over the phone, customers do not deserve ACM neglecting multiple attempts of communication. There were invoices for nearly the same amount of the cost of the insurance. I received the attached document with a check of CAD 127.96 (total costs minus 200 deductible). I requested a reimbursement of the paid amount (CAD 733.83) when contracting ACM as a travel insurance. They have not yet paid the largest invoice for my father when received care at the hospital ( CAD 400). ACM takes no responsibility of the issues. As a customer I am unhappy with the whole process as described. In the future, me and my family will be looking for other companies with better reputation than ACM. Other customers have the right to know the challenges of communicating with ACM, lack of care for customers and patients and lack of taking responsibility when facilitating care and processing claims.

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩