Bul**** into Cancelling Claim

In 2022, I submitted a claim for a condition covered by my Momentum insurance policy, under the plan I had. The claim was for a musculoskeletal disorder.

I followed the proper procedure, but the claim was ultimately rejected. The reason given at the time was that it was denied due to an existing condition. However, this reason had no basis, as there were no specialist records to support the claim of an existing condition.

I appealed the rejection, and the ombudsman initially ruled in favor of Momentum. The decision was based on my dystonia condition, which the underwriter claimed had caused my spinal injury. I contested this, as my specialist had informed me that it was highly unlikely that the dystonia and the musculoskeletal disorder were related. A letter from my treating specialist was provided to both the ombudsman and Momentum. A second appeal was then submitted.

Throughout the entire claims process, Momentum Health has been incredibly difficult to deal with. Their claims division has explicitly asked me to withdraw my claim. They have also threatened to cancel my policy if I do not withdraw my inquiry with the ombudsman. Additionally, they placed my second claim on hold, stating it would only be processed if I withdrew my claim with the ombudsman.

This behavior is completely unacceptable from a large insurance company like Momentum.

When disagreements arise, an ombudsman is supposed to serve as a neutral party between Momentum and the client. It is incredibly hard to trust these services when you are paying as much as you are, only to be threatened and bul**** when making legitimate claims.