Bad unprofessional service

I have been with this medical insurer (STRATUM BENEFIT INSURER)for two years now but hey they have bad service.I have two claims with them that are not been paid and the clams are in the benefits that are supposed to be covered .I dont understand why it is there ,why are are we paying our money if they are not paying our doctors claims.The worse part now their consultants wants to know why you are at the doctors.How is it their business to know.I just think that they are there to make money at our expense.I wouldnt recommend any company to take this insurer for their employees.Now the doctors are threatning me with legal action.