In May, my wife Jennifer ** received a pre-treatment estimate for procedure D2750 Porcelain/high noble crown, showing that Delta Dental would pay $427.80. However, after the procedure was done, nothing was paid. I spoke to two different representatives at Delta Dental and called the Lockheed Martin employee service center. All insisted that it was not paid due to a non-duplication clause for my group. The non-duplication clause does not apply in this case because MetLife (my wife's dental plan through her employer) paid $0.00 for this procedure so there would be no duplication if this claim were paid. The pre-treatment estimate clearly shows how much is supposed to be paid and in the Notes Section, it acknowledges that the benefit is secondary to another plan and benefits have been adjusted based on the non-duplication of benefits. The last Delta Dental representative I talked to confirmed that the insurance company is uncoordinated in accounting for primary insurance in the pre-treatment estimate.
Consumer Complaints & Reviews
I contacted Delta Dental in February 2010 by phone. I mentioned I needed a dental plan to enhance my current insurance plan and they sent me information. I took out a policy starting March 1, 2010 and paid $37.00 per month until August 31, 2011. I never needed to see a dentist until May 2011. My dental office filed a claim for general cleaning. Delta Dental denied the claim. When I called, I was told it was because they were not my primary insurance. Then in July 2011, I was told by my dentist that I would need two major root canals. And the office called Delta Dental to find out how much they would pay, so I could figure out what my part would be.
The next week, I received an e-mail stating they were canceling me, because the plan was for someone that did not have any dental insurance. I told them at that time that they knew I had other insurance, but the first insurance would not pay for major work. That was the sole reason I got another policy and paid out of pocket. I talked with Jennifer **. After our conversation was over, she said she saw no reason to cancel the policy and re-instated it. Then, when I made the appointment to have the work done on my two teeth, the dental office again said Delta Dental said they would not pay for anything. So, I called my bank and stopped payments for monthly premiums. I tried to talk to Jennifer stating that I was paying for a plan that would not pay out anything. And the minute they knew they had to pay a claim, they wanted to drop me.
I called on Tuesday, September 13, 2011, and spoke to Jennifer. I told her since they misrepresented my plan, I asked to cancel the plan and request a full reimbursement of what I paid into the plan. It was a total of 17 payments at $37.00 a month, a total of $629.00. Jennifer sent an e-mail on 9/13/2011 stating my policy was canceled and I would not receive any reimbursement. I then sent an e-mail back to her stating that this was wrong, and they took my money and I wanted it back. Otherwise, I would seek legal council and file a suit. I would like to resolve this matter but will stand by and pay for a plan that never intended to pay out any money back to me.
Please help me resolve this issue so both sides benefit. I don't want to file suit and don't want to go to the media, but will if this is not resolved. It is the best interest of both of us that they pay me back what I paid in premiums. And they should have never written the policy for me, knowing I was employed with the US Dept .of Labor and had insurance. Many people have additional insurance polices to enhance what they already have. Consumer, please be alert about this insurance company. I do want an attorney to contact me or I will seek one myself. I will sue in the court of law and contact media to get the word out.
For over a month, I have been attempting to pay my bill. I have as of now spent over 3 hours on the phone with Delta Dental's service representative, never the same representative twice. We have three different residences; Hawaii, Washington State and New Westminster, BC. I used my wife's Visa card which lists both the New Westminster, BC and Seattle address for credit card usage. Several times I was told by Delta Dental that the bank did not recognize the address. Each time, my wife phoned the bank and was told that the bank had authorized payment but that Delta Dental had cancelled the transaction at their end.
Frustrated, I phoned Delta Dental to pay the bill and received the same runaround about the address. My wife once again phoned the bank and was assured everything was OK at their end, but that it appeared that Delta Dental did not have software to check for both a primary and secondary address. We phoned Delta Dental again to inform them that their software failed to search for a secondary address. We were informed that we could send a check or money order, but they could do no more than that. When asked to speak with a supervisor, we were unable to get someone who could solve the problem. This has not been an issue with several other agencies or companies. There are probably many senior AARP insurers who have multiple residences. This company is failing its customers and its payment practices are antiquated.
