First Financial Funding Group

Dear Revdex.com and Ms [redacted] : IMG received the claim on 1/10/2018, and the claim was processed on 2/15/ Yours truly,Carolyn RO [redacted] Assistant to General CounselInternational Medical Group, Inc

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below [All reviews of this company on Revdex.com website are star only along with a lot of complaintsAs a customer, I believe there is a reason for thatFor my case, since this company is selling their plan on the website with explanations and etc., there is no doubt their plan should at least be able to cover somethingSame as what they have mentioned in their response email, my mom has visited doctors multiple times with different symptoms, if none of them is covered, I would really like to know what they cover, if they can give us some examples! Also, if this plan is such terrible that not cover anything or only cover limited things, why they are still selling it and customers are buying it? Please don't take customers as stupid people, I believe the only reason that they sell this kind of insurance plan with all those "attractive" conditions and price is trying to fraud/trick their clients; they are expecting us not to visit a doctor, and even we did, they will not cover with "proper" reasons/explanations always! Since they will not cover anything, all I want is to at least get my $700+ insurance fee returnedWhat they have mentioned those questioned statements are simply ALL the doctor visits my mom did during her stay in the US.] Regards, [redacted] ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below My original complaint was lodged as a representative from the Insurance company already categorically stated that my claim was not valid for the reasons stated in my original claim The company is now changing its stance and stating that a claim form must be submitted If this is the case, why was it not communicated earlier.I shall submit a claim as required but I still require clarification on how the insurance company can sell travel insurance and expect the person to be insured for days before a claim could be submitted If I resided in the USA for days then I would NOT require travel insurance Regards, [redacted] ***

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined the response would not resolve my complaint For your reference, details of the offer I reviewed appear belowmy ID is [redacted] Regards, [redacted]

Dear Revdex.com: The claims of Mr [redacted] have been adjudicated in accordance with the insurance certificateYours truly, Carolyn RO [redacted] Assistant to General Counsel

The person submitting the complaint does not appear to be the insured person An authorization has not been provided by the insured person allowing the release of PHI or PII to third parties That form can be accessed via http://www.imglobal.com/pdf_forms/claimform-interactive.doc Information regarding any amounts paid, dates of payment, and medical providers paid can be reviewed within Explanation of Benefit statements communicated to the Insured Person or accessed at https://myimg.imglobal.com If the Insured Person disagrees with any decision(s) communicated, the Insured Person may ask the Company to reconsider that decision and supply medical records and opinions to support the appeal The Company will then reconsider its decision based on review of any additional documentation and facts and advise the Insured Person of its decision

In review of the file for Ms***, doctor visits/claims were submitted for the period January - May 2017, with several physicians Medical records were requested from each physician, with not all physicians promptly providing the requested records The Claims Review Team pulled all the information together and the claims are being adjudicated in accordance with the certificate of insurance, and Explanation of Benefits should be sent within the next week.If you have any additional questions, please let me knowYours truly,Carolyn RO [redacted] Assistant to General CounselInternational Medical Group, Inc

An authorization allowing the release of PHI, PII, and NPI has not been provided, therefore, confidentiality and privacy laws will not permit the sharing of that information with a third party Another copy of Explanation of Benefit statements, declarations of insurance, and insurance contracts can be reviewed at https://myimg.imglobal.com/ Eligibility determinations, benefit verifications, coverage decisions, and payment of benefits can be determined only after a complete PROOF OF CLAIM is submitted, an opportunity for reasonable investigation and/or review is provided, cooperation is received, and all facts and supporting information, including relevant data, information and medical records are presented in writingCertain items must be submitted by the Insured Person to be considered a PROOF OF CLAIM eligible for consideration including but not limited to a completed, timely, signed claim form The Insured Person has days from the date a claim is incurred to submit a complete PROOF OF CLAIMIf the Insured Person wishes to submit Proof of Claim, the form located at www.imglobal.com/en/client-resources/claims.aspx will need to be completed and returned along with medical records related to the charges A review of the medical records, any additional documentation, and the facts will be undertaken and the Insured Person will then be advised that decision

The individual is not the insured Without an authorization from the insured, confidential and private information cannot be shared with third parties Another copy of the declaration of insurance, insurance contract, and Explanation of Benefit statements can be accessed via [redacted] Certain items must be submitted by the Insured Person to be considered a complete Proof of Claim eligible for consideration of coverage including but not limited to a completed, timely, signed Claim Form and authorization for release of information The insured has days from the date a claim is incurred to submit a complete Proof of Claim If the Insured Person wishes to submit Proof of Claim, the form located at www.imglobal.com/en/client-resources/claims.aspx will need to be completed and returned.In the event the Company denies all or part of a claim, the Insured Person can appeal the denial under which there will be a review of the claim and the determination Insureds have days from the date the notice was mailed within which to appeal the determination, and have the opportunity to submit written comments, documents, records, and other information relating to the claim The review will take into account all comments, documents, records, and other information submitted by the Insured Person relating to the claim, without regard to whether such information was submitted or considered in the initial claim determination Upon receipt of a written appeal from the Insured Person, the Company shall have an opportunity for further reasonable investigation and review, and will respond as soon as reasonably practicable and within days

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below [I already sent written email few months back on the concern with claims rejected stating pre-existing condition even though it is notBut no action from insurance companyI was told to contact doctor office to discuss further & not with insurance companyI am getting bill dues from Doctor office as claims were rejected] Regards, [redacted]

An authorization allowing the release of information protected under confidentiality and privacy laws has not been supplied If an answer to a specific benefits or coverage question is required for any reason, the Insured Person may submit a written request to the Company, including all pertinent medical information and opinions, and a written reply will be sent by the Company

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and have determined that the response would not resolve my complaint For your reference, details of the offer I reviewed appear below [Provide details of why you are not satisfied with this resolution.]Response received was generic process information and nothing specific to my issue Regards, [redacted]

The individual submitting the complaint is not the insured or the patient Neither the insured nor the patient have authorized the sharing of information protected under confidentiality and privacy laws with third parties such as your organization.In the event the Company denies all or part of a claim, the Insured Person has a reasonable opportunity to appeal the denial under whichthere will be a review of the claim and the determination Insured Persons have the opportunity to submit written comments, documents, records, and other information relating to the claim The Company’s review will take into account all comments, documents, records, and other information submitted by the Insured Person relating to the claim, without regard to whether such information was submitted or considered in the initial claim determination Upon receipt of a written appeal from the Insured Person, the Company has an opportunity for further reasonable investigation and review, and will respond in writing to the Insured Person as soon as reasonably practicable

If any insured needs another copy of their insurance information, the ability to access the insurance contract, declaration of insurance, and ID cards, submit claims, view claim status, and pre-certify treatment is available by visiting https://myimg.imglobal.com Eligibility determinations, benefit... verifications, coverage decisions, and payment of benefits can be determined only after a complete Proof of Claim is submitted, an opportunity for reasonable investigation and/or review is provided, cooperation is received, and all facts and supporting information, including relevant data, information and medical records are presented in writing. Eligible Medical Expenses under this insurance previously paid by the insured person at the time of the Company’s favorable adjudication will be reimbursed. Claim settlements, payments and reimbursements remain subject to the deductible, coinsurance, limits, and all other Terms of this insurance. Information regarding amounts paid, dates of payment, and medical providers paid can be reviewed within Explanation of Benefit statements communicated to the insured person or accessed at https://myimg.imglobal.com

If the Insured Person disagrees with a decision of the Company, the Insured Person may in writing ask the Company to reconsider the decision and supply medical records and additional documentation to support the appealThe Company will reconsider its decision based on review of any additional documentation and facts The Company will then advise the Insured Person of its decision within a reasonable time frame following receipt of any additional documentation and facts

An authorization has not been provided by the insured person allowing the release of PHI or PII to third partiesThat form can be accessed via http://www.imglobal.com/pdf_forms/claimforminteractive.docInformation regarding any amounts paid, dates of payment, and medical providers paid can be reviewed within Explanation of Benefit statements communicated to the Insured Person or accessed at https://myimg.imglobal.comIf the Insured Person disagrees with any decision(s) communicated, the Insured Person may ask the Company in writing to reconsider that decision and supply medical records and opinions to support the appealThe Company will then reconsider its decision based on review of anyadditional documentation and facts and advise the Insured Person of its decision

Dear Revdex.com and Ms [redacted] :IMG has not received enough information to match Ms [redacted] as an Insured If you can provide a Certificate number or Insured ID number, I will be happy to review your fileYours truly, Carolyn RO [redacted] Assistant to General CounselInternational Medical Group, Inc

Revdex.com: I have reviewed the response made by the business in reference to complaint ID [redacted] , and find that this response/resolution is satisfactory to meAlthough there is still one account still awaiting a response I would rather have had an apology in addition to the resolution but I am very grateful that at last the issues are being settled Regards, [redacted] ***

In review of the file, the request for cancellation was made after the month of coverage had started The request for cancellation was denied correctly, in accordance with the insurance plan, only full unused months of coverage are refunded, and must be requested prior to the coverage period The cancellation request was made on January 31, 2017, and for coverage refund it would have to have been received prior to January 27, Yours truly, Carolyn RO [redacted] Assistant to General CounselInternational Medical Group, Inc

Revdex.com:
I have reviewed the response made by the business in reference to complaint ID ***, and have determined the response would not resolve my complaint. For your reference, details of the offer I reviewed appear below
This correspondence was made long after my complaintAnd well over days is not
Regards,
*** ***