LM
Lorraine M

1 reviews | Active since Aug 2020

01 Feb 2024, 23:40

Declined claim/ claim not paid to date

I have a complaint I submitted a claim for hospital at this company and it was declined due to them saying my dependent didn't finish waiting period, to my surprise the previous claims were paid without any waiting period mentioned, the contract I requested doesnt stipulate that, they further told me that the contract which is according to them the original one was posted to my address and I have never received, how was I supposed to know about the 12 months waiting for pre existing conditions if I didn't receive the one that was sent to my address the one sent on email doesn't stipulate that only 3 months waiting period was mentioned policy number *** I need this claim to be reviewed and my money paid claim was declined december 2022, it's not my fault that the consultant who assess this claims don't know what they are doing Second policy number is ***

The claim was submitted in December 2023 or late November 2023 to date they haven't paid me they keep requesting documents from me when I sent this they request this when I sent that they also requesting something else, this is terrible when one took out this policies no one mentioned all this stupid requirements but when you have to claim is one thing after the other, why was this required documents not mentioned on the contract? That I received on my email?

If I miss one premium communication is sent but when claim requirements are updated no one keeps us informed why? So none of this are mentioned so that we can take this policies knowing very well that they won't be paid? If that's the case then my next step will be ombudsman

You cannot deduct money for so many years when I claim I'm taken from pillar to post I need this resolved

0
Replies (1)
Metropolitan Life
Metropolitan Life's reply02 Feb 2024, 08:56
Official
Dear Lorraine M
 
We acknowledge receipt of your complaint.
 
As Metropolitan we strive in providing excellent service to all our clients. 
 
We confirm that we are busy investigating your complaint.
 
One of our escalation specialists will revert to you shortly. 
 
Yours sincerely, 
Client Care Team