Complaint Review: First Mutual Insurance Group Inc.

Derrick Jenkins <fmigjenkins@gmail.com> Wed, Jun 20, 2012, 11:50 AM     to Tim       Hi Tim,   Based on our last conversation, I was under the impression that you were working with Humana directly.  I was left with the impression that the representative had provided some options for you as you had requested.    I closed out your file in our agency system and tried to wish you the best with your coverage situation.  I also let you know that I would be glad to help if you had any claims issues in the future even though we agreed it would be best for you to work directly with the carrier.     I did not realize you would be cancelling coverage completely.  If I had known that, I would have advised you to cancel the coverage in writing.  (Agents are not allowed to cancel coverage with Humana.)   I know I was unable to call, but I did respond to your concerns as quickly as I could when I was informed that you had not received a refund. I am not in a position to help with the billing department if I am no longer your agent, but I would have helped you get a supervisor involved if necessary.   Regardless of your filing of complaints, I am still willing to see if there is a way to help you.  If you feel you have the situation under control from this point, I will bow out.  If you need me to contact a supervisor to rush a refund please let me know.    I know you are upset at this point, but you seem like a very nice person and I hope that Humana handles the refund for you in a timely manner.  (Please make sure you have cancelled in writing.)   -Derrick

First Mutual Insurance Group assists hundreds of consumers in 25 states every month.  In fifteen years, we have helped tens of thousands of consumers shop insurance rates to ensure the best coverage at the lowest possible rate.  When it comes to submitting an application for insurance, we only work with the highest rated carriers.  In this case, we shopped and determined with the client that Humana was the best option.  The nice thing about the Humana policy was that no money was due at the time of the application, but they do draft at the time the policy goes into effect.  (Most companies require the initial premium is submitted at the time of application BEFORE an applicant even knows whether or not they will be approved.  Most companies also have a non-refundable application fee...Humana had no application fee.)

Client states "Upon gaining approval for my individual insurance and had a slight rate adjustment from what I was quoted, no big deal. I called this guy Brent, who by the way, daddy is the owner. I ask him what are the other rates for the other policy types and I want to add dental. He says he'll call me back tomorrow.  I leave out of town for two seperate business trips and didnt hear from Brent."  

Response:  Kind of hard to follow up if a client leaves for two separate business trips.  Client lives in AZ, we are in TN which causes a time difference.  This may have caused Brent to have to schedule a call back to provide the dental quote.  Typically, most policies are within a few dollars of each other, but Humana was the best option based on the client's zip code and demographic.  If client was not happy with the rate adjustment, we would have made a plan change, but because client intially liked the coverage and the rate was acceptable and the client further wanted to add dental, it didn't appear that there was any dissatisfaction with the plan.  All insurance policies have a start date on an application.  It is the only way to determine an accurate rate.  This client called us to secure coverage and one of the first questions we have to ask is "when would you like coverage to begin?".

Brent is my son and I know he is always very clear in explaining the benefits as well as the process.  At the time of this application he had over five years experience and has consistently been one of the top producers in the country. 

It was unfortunate that the applicant was admittedly travelling and his travels extended beyond the effective date which is the only reason money was taken for the policy.  (If an insurance company is obligated to cover a claim after a specific date, the premium must be in hand for the carrier.)  

Brent was correct in explaining that the client has a 10 day free look policy from the date the policy is received by the consumer.  During this time, changes or a cancellation can occur with no obligation to the consumer.

When I was told this client was upset, I called him personally.  I had no doubt that Humana would provide a full refund and made sure the client knew that I would personally help him cancel the policy and ensure his refund.  As an agency, we do not actually handle any client premiums, so we are always at the mercy of the carrier in processing refunds.  I did explain that he should reach out to me if he did not receive the refund within 10 business days.  I did not hear back from the client and was VERY surprised when he posted a negative report.    

The client received the refund within days of this complaint and this issue was resolved.  Unfortunately, Brent was the focus of the frustration in this case, but he has helped hundreds of customers each month in securing health, accident, critical illness, life, dental, and vision coverage.  Not always easy dealing with the insurance companies, but First Mutual does stand with the client and this client did recieve the refund.  

Both Brent and I have been on both sides of the equation when it comes to health insurance.  He lost his mother, my wife, at the age of 17 after a three year battle with cancer.  As an agency, we truly strive to take an empathetic approach to each consumer's situation and work diligently to ensure the client makes the best choice in coverage.  We are a servicing agency that acts as a field office for carriers such as Blue Cross, United, National General, and others.  I regret that this client had a bad experience initially, but we truly do everything we can to avoid these types of issues.  A shame that the refund took a few extra days to be recieved, but a response was needed to clarify this issue from our agency's side.

 Sounds like this rebutt is familiar

WHY would you even THINK of giving them your account info when you state that you werent sure of anything to begin with?  There is no earthly reason to give anyone your financial information. You had to know  something like this would happen.  I dont care what the promises were, how he conned you or cajoled you......YOU SHOULD HAVE KNOWN BETTER.

I'll be surprised if you ever see your money returned without a huge battle.