Complaint Review: AMLI(American Medical and Life Insurance Company

We were sold this discount assurance plan with an accident rider on it (max. $4000.00) 4 yrs ago. In April of '09 we were in a car accident which required surgery on my hand, followed by therapy. I called the company right away and was told thatI had to wait for all fees and charges to be paid in full first, which I did. In the late winter of 2010 I filed the claim and began the process of providing the necessary paper work and information to them and then waited for a reply, after a couple of weeksI called them back to check on the status of the claim, this is whenwhat now appears to be the excuses began.

It started with , we didn't get the paper work from your DR., then they didn't get it from the therapist, then someone was out for several weeks and then they determined they hadn't recieved the "right" paper work and we had to request something called a "form 1500" which, after speaking tomy Dr. and therapists office, isn't soemthing they normally have to provide and didn't have. I had to go to my Auto Insurance company to get them. After providing all this material and waiting again for at least 2-3 weeks for a response ...

I called them to once again check on the status, it was hten that I was informed that they had forwarded my paper work to their payment distributor, Hammerman and Gainer, who, after several calls, I was finally able to speak to a person who informed me she didn't know whatI was talking about. It was after some "investigation" that we found out that AMLI had "lost" my paper work...so here goes another month before they find them and send them to H&G. by now it is Oct/Nov. 2010. At this point i am calling them once a week and the ususal response was we are still working on them, I'll let you know as asoon as we have an answer...in late Dec. early Jan.

I recieved an e mail from the agent assigned to my claim, stating it didn't look like they were going to pay it...then about a week later she called with"good news" they had approved my claim and were sending a check for somewhere between $900.00/$1000.00. Iwas glad to hear this but did ask to see what it was they were paying on because this was an 80/20 policy and this was definately short of that amount. She sent me the list of services that they had agreed to pay on and it wasabout 1/5th of the whole charges incurred in the accident. I replied to her e mail thanking her for her work but also to uinform her that these were not all of the charges,

To date not even the promised payment has been recieved and according to the e mailthat just came in they said "what ckaim are you rewferring to" we have paid on your husbands claim and do not know what other claimI am talking about, but ifI have the paper workI should file it. It is clear to me now that these people are running a scam, I have all the correspondence and e mails between us, plus names andphone numbers of everyone I had to deal with regarding this claim. Please be advised not to do business with anyone from any of the above named companies as they have several that they are affiliated with, if anyone has any information about these people or advice on what to do going forwardI would appreciate it greatly.