Complaint Review:
Trip Mate Inc.
Trip Mate, Inc. TravelSafe Insurance Non-Payment of Claim Kansas City, Missouri
-
9225 Ward Parkway
Kansas City, Missouri
United States of America
-
1-800-888-7292
Web:
-
Tripmate.com's web site claims that "payments will be finalized within five working days after we receive all necessary information."
They have all the necessary information in their hands since the beginning of this year, and my wife still hasn't been paid the modest amount of US $146, which is her medical claim. They have been dragging her for almost four months now. See here-below Tripmate's activity log regarding her claim.
I believe Tripmate follows unethical business practices: they delay payment for months and months until you give up and forget about your claim. Customer.
---------------------------------------------------------------------------------------------
Tripmate Activity Log
Claimant: [my wife's name]
Claim: MAI-xxxxxxx
plan number: 925
---------------------------------------------------------------------------------------------
04/16/2010 FYI MESSAGE
04/15/2010 REFERRED TO CLAIMS ASSISTANT
04/15/2010 3RD REQUEST FOR EXPLANATION OF BENEFITS
04/09/2010 FYI MESSAGE
03/26/2010 FYI MESSAGE
03/25/2010 REFERRED TO CLAIMS ASSISTANT
03/25/2010 2ND REQUEST FOR EXPLANATION OF BENEFITS
03/25/2010 CALL TO PARTY OTHER THAN CLAIMANT
03/24/2010 FYI MESSAGE
03/22/2010 FYI MESSAGE
03/06/2010 FYI MESSAGE
03/04/2010 REFERRED TO CLAIMS ASSISTANT
03/04/2010 REQUEST FOR EXPLANATION OF BENEFITS
03/04/2010 CALL TO CLAIMANT
03/04/2010 FYI MESSAGE
03/03/2010 FILE TO CLAIMS DEPARTMENT
03/01/2010 REC'D MISCELLANEOUS INFORMATION
02/27/2010 FYI MESSAGE
02/16/2010 REFERRED TO CLAIMS ASSISTANT
02/16/2010 2ND REQUEST FOR EXPLANATION OF BENEFITS
02/16/2010 CALL TO CLAIMANT
02/16/2010 CALL TO CLAIMANT
02/16/2010 CALL TO CLAIMANT
02/16/2010 CALL TO CLAIMANT
02/16/2010 FYI MESSAGE
01/29/2010 FYI MESSAGE
01/26/2010 REFERRED TO CLAIMS ASSISTANT
01/26/2010 REQUEST FOR EXPLANATION OF BENEFITS
01/26/2010 CALL TO CLAIMANT
01/25/2010 FYI MESSAGE
01/14/2010 FILE TO CLAIMS DEPARTMENT
01/13/2010 LOSS NOTICE PRINTED FOR FILE
01/13/2010 PURCHASE OF PLAN CONFIRMED
01/13/2010 PAYMENT FOR PLAN CONFIRMED
01/12/2010 ACKNOWLEDGMENT LETTER SENT
01/05/2010 RECEIVED COMPLETED CLAIM FORM
12/21/2009 CLAIM FORM COMPLETED ONLINE
12/21/2009 CLAIM REPORTED ONLINE
1 Updates & Rebuttals
GaleS
Overland Park,Kansas,
United States of America
Observation
#2UPDATE Employee
Fri, September 17, 2010
I am an employee of Trip Mate, so let me see if I can make some sense of this.
Based off what I see in this activity log is that we have requested the Explanation of Benefits from you a number of times. It is clearly written in your plan that we are an excess coverage for medical, which means we do NOT take the place of any existing health insurance you might have. We understand that Medicare may not cover out of the country medical claims, but you do still have to submit it to your secondary (if you have one) and so forth before it comes to us. Any expenses not handled by your current health insurance provider/s would then come to us for review. It may seem unfair, but it is outlined in your plan.
As far as this claim being "dragged out" for four months, we are required to go over with each customer the documentation that they'll need from the moment their claim is initiated. This means that if you've called in the claim and set it up with a representative on the phone, that rep is required to tell you that the Explanation of Benefits is part of what we'll need to process the claim. In addition to this, it also outlines it on the front of your claim forms. You are then responsible for obtaining that document to submit to us for review. From the point that ALL necessary documentation is received, the review process begins. So the claim has not been "dragged out" by us, the review process has merely been delayed by your failure to submit the appropriate documents to us.
Remember: We are bound by laws and restrictions too. We need these documents in order to appropriately review your claim. We are subject to audits and fraudulent claims, so that is why certain documents are absolutely required in order to review and (hopefully) pay out a claim. What most people don't even realize or think about is that we pay out over 95% of our claims. Keep that in mind the next time you have a complaint to make about our company.
In the future, I strongly suggest you read up on the plans you're purchasing before you actually buy one. Some plans do offer primary coverage in health, such as the Nationwide plans. Perhaps look into those; that way, you can get around the Explanation of Benefits requirement.