1 Jan, 2018 → by ClaimboUser438887
Refusal to Pay on Claims
*SOLVED

3

On more than one occasion claims were submitted to Delta Dental of Rhode Island and on more than one occasion there was a refusal to pay with tons of double talk on their part. A claim was made for the balance of orthodontia work. They cover this work, but the work was started by Met Life and they used the excuse that because we started with Met Life, Delta Dental would not pay the remaining few hundred dollars. They said if we had started the work with them they would have paid the balance. Does this make any sense? The next problem was they would not pay for a root canal evaluation because they said I had one this year. It costs $85.00 and my balance for the year is between $600 and $700. What difference does it make if I had one for the year. I have the allowance so why can't I use it? My husband had periodontal scaling done, but they would not cover it because they said he had no history of gum problems. How is one supposed to have a history of something if they cannot begin one? I have never had issues like this with other insurers. I feel that whenever a reasonable claim is made this company is going to throw a monkey wrench in and not pay up. What does one do? We pay premiums and opted for the "best plan" they offer and this is what we get. Unfortunately, we do not have a choice in the matter, as this is what my husband's company offers. What will the next denial be?
Helpfull? 0 votes

Post your comment:



Do you want to help? Probably you've just been in a similar situation, know the solution and want to help? Perhaps you are just a kind person who has advice on the merits. Please write your comment — you can do a good breed.

If you are actual Representative of Delta Dental Plans Association you can contact the user using the comment form and help resolve the situation. The user can always mark his complaint as "resolved". Maintain your brand image, it is FREE.

Copyright © 2023 CLAIMBO.COM. All rights reserved.