Complaint Review: Mega Life And Health Insurance Company - North Richland Hills, Texas

MEGA Life, NASE, PFL

I have had their Catastrophic Hospitalization Insurance. Basically a $5000.00 deductible and up to 10k they pay 80% after that it is 100% of the charges. Now I bought this back in 1986, in 1993 I had a brain tumor and the company I was working for paid for the operation. Then I thought really, PFL, Mega is my primary Insurance company. Their first coverage.

I called the company and told them this and they were over joyed, as it was a self insured company and the employees provided the pool of money. There was no problem, PFL picked up the cost, as they are my primary insurance company. The cost was $397,000.00 for the operation, MEGA PFL paid everything, that was covered. To say the least I was very happy with the company and though my rates are almost $700 per month for just my coverage, I recommended them to everyone.

Now they have decided that they are no longer my Primary Insurance Carrier, that my wife's coverage from her job is primary, medicare comes second as I am on SSD and Mega PFL is third.

How can they do this, they have been my primary insurance since 1986, my wife has had many jobs, no guarantee this will last.

This was all done with out my knowledge except the billing person at my Primary Doctor mentioned this when she was trying to refund money to Mega PFL. This has to be the biggest rip off and I am sure highly illegal.

They are doing it because all my wife's company had to do is deny the claim and it goes to Medi Care and then PFL. I am not 65, no where near that. So all PFL would have to pay, is what Medi Care did not pay, at the Medi Cares rate of about 37% of a Doctors normal charge. What a scam and a terrible thing to do for those who need Medi Care.

I intend to contact Medi Care Fraud Department as this was all done behind my back and I am not even required to keep the Medi Care, it's just an option and Medi Care has never paid a dime. With 2 other insurance companies ahead of them. I think this is collusion between the two companies to with hold payments on care and medications that I need, turn it over to Medi Care and MEGA PFL only pays what little Medi Care does not play.

I must say I am surprised, not all that much, but still surprised, as MEGA PFL has paid for the things they were responsible for till now. As I read through their list of problems, I remember back to the interview with the agent. She was brand new and I had to reminder her there were a couple of questions she could not ask.

I figured if I was getting pushed around, so must others be experiencing what I am today. I am shocked, but pleasantly at the agents that have come forward to say how this company does business now and reveal how it acts and operates behind the scenes.

This takes courage, that is so lacking in most people today. Their saying that they were duped and told false promises and not kept up date on their policies by the company they were selling for. This takes courage to admit you made a mistake in life and come forth to warn others. That is inner strength.

I only wish I had kept track of the company, with the rate increases I would think they were happy, but it is clear their has been collusion among the 2 insurance companies and I will be the loser. If any one knows about this happening or if they can do it with out notification, I would appreciate it. Also how to get to the people who make the decisions, I do not want to spend days going through the phone tree. This will really hurt me, I just don't see how they can assign positions, when I have been with them for 21 years and they have always been my first insured. Then swap with another company and assign a government benefit Medi Care at the second position. Who gives them that right. Now they say where the Government will pay

Any help or ideas most kindly requested and accepted. They sure have changed since 86.

Geoffrey

Big Lake, Alaska

U.S.A.