Monday, July 23, 2007

Incredibly Stupid Carrier Trick

[Welcome Industry Radar readers!]
As we've long-chronicled, insurance companies seem bent on making gummint-run programs more appealing. This one, though, may well be the most egregious example of inept, thoughtless incompetence yet:
Several years ago, I wrote health insurance for a nice, middle-aged couple, whom we'll call Frank and Ethel. We used Anthem (BX) because they offered good benefits at a reasonable price, and (at the time) were more liberal in their underwiting (Frank had some health issues). The plan was issued, and all was well.
Until early May, when Frank passed away following a brief illness. As required, we notified Anthem, in writing, that he had died, and would they please:
a) Remove him from the plan
b) Refund the premium paid on his behalf for the balance of the month in which he died
c) Let us know Ethel's (new) premium
d) Issue a new ID card for Ethel
None of this strikes me as particulary challenging; indeed, it's a relatively routine thing (well, for the carrier; I don't have a LOT of insured's dying every month). We sent this a week or so after Frank died, and waited.
And waited.
And waited. After several weeks went by, we became concerned that this was taking so long. It was especially problemmatic for newly-widowed Ethel, whose finances were, to put it mildy, shaky. So I called down to our service rep, who informed me that Anthem had "lost the letter," and asked if I could resend it. Since I had it in the computer, that was a fairly simple process. The bigger problem, though, was that Anthem had already drafted the June premium, which still included the deceased (who didn't really need the coverage). And now it's July, and guess what, they did it again! We finally sent down another letter, asking to stop the automatic withdrawls, and just send a bill.
The good news is that Anthem did stop the automatic withdrawals.
The bad news (and you just knew there'd be more of that, right?) is that the new bill shows Frank (and reflects his premium) but not Ethel. That's right, the dead guy has health insurance, while his widow doesn't.
There is simply no excuse for this kind of sloppy "customer no-service." It's bad enough that this poor woman has lost her husband, but to be constantly reminded of it (every time she checks her quickly diminishing bank balance) is unconscionable. We're still working our way up the food chain that is Anthem "customer service," and will keep you posted on any progress we're able to make.
UPDATE: Okay, just spent another hour on the phone with Anthem, and the situation appears to be resolved.
Essentially, when Frank died, they cancelled Ethel as well, and moved her to her own policy. The new policy has the same benefits and premium; it's really an internal mechanism resulting in her being assigned a new policy number as of the date of Frank's death.
Unfortunately, they didn't get around to accomplishing this until about 10:00 this morning (seriously!). Thus, it appeared on their records that Ethel had also died. As an aside: what a great deal for Anthem; they get the premiums, and dead folks file few claims.
In the event, Anthem proposed to credit the amounts Ethel was dinged in May, June and July to future premiums; I demurred, emphatically. Eventually, we arranged for Frank's premiums to be deposited directly back into Ethel's checking account, they would move her premiums from the old policy to the new, and she would begin August with a clean slate, a new policy number, and an appropriate premium.
I'd like to say that "all's well that end's well," and indeed, Ethel has mentioned several times how pleased she's been with how Frank's claims have been handled throughout this ordeal.
But the fact remains, the company fell down on this, big time, rarely returned calls, prevaricated in their answers and generally made a sad situation worse. That it took almost 2 ½ months to get this relatively simple transaction resolved is unacceptable, even for an insurance company.
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