ComplaintsforThe Loomis Company

• Initial Complaint

  08/18/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I went through **** for Vison and dental insurance I guess. I went for health insurance I just learned 08/2023 it was for Vison and dental m. I originally signed up 2020 Ive never received an insurance card so I cancel 2 months later got my own insurance. I found out they were still charging my card 05/2022 cancel again. Only to found out 08/2023 that they are still charging my card. Staff stated they only take cancellations through email. I dont have any type of contact information from them and if Im paying insurance I should be receiving some type of **** to file that on my taxes never received one from them. I asked for my money back and was told I couldnt get my money back for the inconvenience. 65 dollars for three years? This insurance is a scam.

  Business response

  08/31/2023

  Dear ******* *****,
  

  We are in receipt of the complaint filed by the Consumer with your office dated August 25, 2023. We have responded to the Consumer directly as we legally cannot provide any related documentation or information to your office as we do not have a HIPAA authorization on file.
  

  Under federal law, we are prohibited from releasing this requested personal information without a signed release.
  

  Please be advised that the information contained herein is meant to be responsive to your inquiry. 
  

  It is not meant to constitute or be construed as a waiver of any other defense available to the Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense provided for under the Policy and/or applicable law. If anything further is required, please contact us again. 
  

  Sincerely,
  The Loomis Company

• Initial Complaint

  04/27/2023

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I purchased a short term healthcare plan through The Loomis Company. It was to extend for six months and then automatically cancel. Apparently, there was some kind of separate additional prescription plan that was part of the original payment that carried on separately after the expiration in September 2022. There was an additional amount deducted monthly after what I thought was the expiration date. Since I was traveling for six months, I was not aware fully of this until I returned and reached out to see why they continued to bill me approximately $85 a month. I also asked that it be canceled. They refused to cancel it back to the date that the short term insurance canceled and only gave me a refund for the month I had prepaid. When I reached out to Loomis directly, they refused to adjust the cancellation date. Going online and checking out customer reviews, I realize this is a consistent negative occurance for this company. I would normally have checked them more thoroughly, but was directed to this company when I contacted **** . **** transferred me to a Loomis Rep when I explained I needed short term health coverage. My experience with **** has been excellent so I interpreted this hand off as an endorsement of The Loomis Company. I would like a full refund for the month beginning September 2022 up until April 2023.

  Business response

  05/11/2023

  Dear ******* *****,
  We are in receipt of the complaint filed by the Consumer with your office. We have responded to the Consumer directly as we legally cannot provide any related documentation or information to your office as we do not have a HIPAA authorization on file. Under federal law, we are prohibited from releasing this requested personal information without a signed release.
  Please be advised that the information contained herein is meant to be responsive to your inquiry. It is not meant to constitute or be construed as a waiver of any other defense available to the Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense provided for under the Policy and/or applicable law. If anything further is required, please contact us again.
  Sincerely,
  The Loomis Company

  Customer response

  05/11/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:
  i was unable to view the Loomis companies response as I had difficulty with their attachment.
  
  Regards,
  
  *****************************
  

  Business response

  05/11/2023

  We are in receipt of the complaint filed by the Consumer with your office. We have responded to the Consumer directly as we legally cannot provide any related documentation or information to your office as we do not have a HIPAA authorization on file. Under federal law, we are prohibited from releasing this requested personal information without a signed release.
  Please be advised that the information contained herein is meant to be responsive to your inquiry.
  It is not meant to constitute or be construed as a waiver of any other defense available to the Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense
  provided for under the Policy and/or applicable law. If anything further is required, please contact us again.
  Sincerely,
  The Loomis Company

• Initial Complaint

  04/17/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I previously had a policy that I canceled September 2020. I did not renew this policy nor did I sign any agreement for reinstatement of this policy but started being charged again almost 2 years later in April 2022. I contacted the company December 2022 to cancel the policy and issue a full refund of $388.62 that I was wrongly charged but was only given a 1 month refund of $43.18. When trying to contact customer service I was told my account was not found. I was wrongly charged for a policy I never requested or approved and was thus unaware existed and should be refunded the full amount.

  Business response

  06/09/2023

  Dear ******* *****, 
  

  We are in receipt of the complaint filed by the Consumer with your office. We have responded to  the Consumer directly as we legally cannot provide any related documentation or information to  your office as we do not have a HIPAA authorization on file. Under federal law, we are  prohibited from releasing this requested personal information without a signed release. 
  

  Please be advised that the information contained herein is meant to be responsive to your inquiry.  It is not meant to constitute or be construed as a waiver of any other defense available to the  Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense  provided for under the Policy and/or applicable law. If anything further is required, please  contact us again. 
  

  Sincerely, 
  The Loomis Company
  
  

• Initial Complaint

  03/23/2023

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Called to Loomis billing department to update billing information and make an early payment with the specific intent withdraw permission to monthly auto bill my **** checking account and provide a credit card for payment. The Loomis customer service representative billed wrong payment method, never billed the updated payment method then canceled my dental plan without my verbal or written request. I never cancelled my dental plan verbally, telephonically or in writing. Request $81.79 billing adjustment for dental plan cancelled by Loomis.

  Business response

  05/08/2023

  Dear ******* *****,  
  

  We are in receipt of the complaint filed by the Consumer with your office dated 03/23/23. We  have responded and resolved the issue directly with Consumer as of 04/12/23. We legally cannot  provide any related documentation or information to your office as we do not have a HIPAA  authorization on file. Under federal law, we are prohibited from releasing this requested personal  information without a signed release.  
  

  Please be advised that the information contained herein is meant to be responsive to your inquiry.  It is not meant to constitute or be construed as a waiver of any other defense available to the  Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense  provided for under the Policy and/or applicable law. If anything further is required, please  contact us again.  
  

  Sincerely, 
  The Loomis Company 

• Initial Complaint

  03/10/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  This Dental insurance informed me that my dentist will accept this insurance, so then I purchased the insurance to be informed that they do NOT accept them. I informed them through their website and demanded they cancel my membership and give me my refund for misleading me to believe their insurance will cover my dentist.Even after my demand, they continue to take money from me. They are NOT a good company.

  Business response

  06/01/2023

  Dear ******* *****, 

  We are in receipt of the complaint filed by the Consumer with your office. We have responded to  the Consumer directly as we legally cannot provide any related documentation or information to  your office as we do not have a HIPAA authorization on file. Under federal law, we are  prohibited from releasing this requested personal information without a signed release. 

  Please be advised that the information contained herein is meant to be responsive to your inquiry.  It is not meant to constitute or be construed as a waiver of any other defense available to the Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense  provided for under the Policy and/or applicable law. If anything further is required, please  contact us again. 
  

  Sincerely, 
  The Loomis Company

  Customer response

  06/01/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 
  
  Regards,
  
  ******** ****  
  

• Initial Complaint

  03/07/2023

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  HORRIBLE policy terms, conditions, and customer support. I had their EMERGENCY medical insurance coverage. I had a legitimate medical emergency involving an ambulance ride, emergency room triage, plus a two-day hospitalization. They denied all of my claims because they said having a seizure and near-death experience didn't qualify as an accident or emergency. WHAT?!?!?! I nearly died when I was camping/hiking in the mountains by an accident and extreme dehydration. How doesn't that qualify as an emergency? I want a refund for the past year of payment for my policy. They had no intention of providing any emergency coverage.

  Business response

  05/08/2023

  Dear ******* *****, 
  

  We are in receipt of the complaint filed by the Consumer with your office dated March 7, 2023. We have responded to the Consumer directly as we legally cannot provide any related  documentation or information to your office as we do not have a HIPAA authorization on file.  Under federal law, we are prohibited from releasing this requested personal information without  a signed release. 
  

  Please be advised that the information contained herein is meant to be responsive to your inquiry.  It is not meant to constitute or be construed as a waiver of any other defense available to the  Carrier. The Carrier expressly reserves all rights to assert any provision, limitation or defense  provided for under the Policy and/or applicable law. If anything further is required, please  contact us again. 
  

  Sincerely, 
  The Loomis Company
  

  
  

• Initial Complaint

  12/01/2022

  Complaint Type:

  Order Issues

  Status:

  Answered

  More info

  Company scammed me along with another company involved In running a fraudulent insurance disability coverage , case was active when filed And doctor confirmed disability , still they made up a few different excuses as they were determined to never payout in the first place ,wasted a lot of time

  Business response

  05/04/2023

  April 27, 2023 
  Dear *** *****: 
  This letter is in response to the complaint filed by ******* ***** on December 1, 2022. We regret our delay  in responding. This complaint was not received by The Loomis Company (“Loomis”) until April 24, 2023.  Loomis had a technical issue blocking incoming emails from the Better Business Bureau. This issue was not  resolved until April 21, 2023 when Loomis was able to receive *** *****’s complaint. ******* Insurance  Company, Inc. (“*******”) received *** *****’s complaint on April 24, 2023. The complaint was forwarded  to me for a response as ***** Life And Accident Insurance Company manages and reinsures the *******  Benefits Program.  
  The complaint is regarding a claim submitted for coverage under the above-referenced Non-Participating Group Disability Income insurance policy (“DI Policy”) underwritten by ******* I. *** ***** alleges that *******  was determined to deny his claim. To the contrary, ******* properly paid all claims and dedicated individuals  communicated frequently with *** *****. 
  Policy Information 
  *** ***** is a Certificateholder under a DI Policy issued to ******** ******* Association (“***”). Copies of  the Policy and Certificate of Insurance are attached for your reference. The effective date for the DI policy was  October 1, 2020. Loomis is a third-party administrator for *******. Loomis relies on its vendor for eligibility  data for Certificateholders of group. 
  Policy Benefits and Claim Discussion 
  On October 20, 2022, *** ***** saw ***** ****, OD, who treated him for retinal dystrophy and opined that  he was unable to perform his work due to loss of vision. Thereafter, *** ***** submitted a claim under the DI  Policy seeking disability income. 
  
  The DI Policy provides a maximum disability benefit per Insured per month of 60% of the Insured’s  compensation, with a maximum amount of $4,000 per month for a maximum of 12 months per policy period.  The relevant Benefit Schedule excerpt is below: 

  Disability Income Claim Submission Process 
  In order to process claims submitted under any Non-Participating Group Disability Income insurance policy,  ******* requires the Certificateholder to complete a Disability Income Claim Form (the “Claim Form”). 
  The Claim Form requests (i) information about the Certificateholder’s income, (ii) certification by a physician  that the Certificateholder cannot work due to their disability, (iii) relevant medical information, and (iv) the  dates during which the Certificateholder will be out of work. A copy of *** *****’s Claim Form is attached  for your reference. 
  On November 3, 2022, Loomis received the Claim Form via fax. On November 5, 2022, Loomis sent a letter to  Dr. **** to request that she complete missing fields on the Attending Physician Statement, and complete and  return the Pre-Existing Condition Form. Loomis followed up with Dr. **** via letter dated November 21, 2022. *** ***** was copied on both letters. Loomis received the completed Claim and Pre-Existing  Condition Forms on November 30, 2022.  

  Loomis sent *** ***** a letter on December 1, 2022, stating that the claim was denied because the coverage  was not active. At that time, Loomis had not updated the eligibility information it received from its vendor on  the same day, so it appeared that *** ***** was not covered. The eligibility records were updated on  December 9, 2022, and his denial was promptly reversed for claim payment. A letter explaining that he was  eligible to receive benefits and his claim was approved was sent to *** ***** on December 13, 2022. His first  disability benefit payment was also sent on the same date. 
  

  The chart below outlines the payments issued under *** *****’s DI Policy. 
  

  Conclusion 
  Due to the timing in receiving eligibility information from Loomis’ vendor, the claim was initially denied.  Upon receipt and updating of the eligibility data, the claim was quickly reversed and a check and approval letter  were sent twelve days later. *** ***** received payments under the DI Policy for the past five months for his  infirmary. We regret the delay in approving *** *****’s benefits and the inconvenience he has experienced. 
  

  Please contact me directly if you have any further questions or concerns. 
  

  Respectfully, 
  
  Sr. Director and Associate General Counsel 
  Globe Life Benefits 

  Customer response

  05/04/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:  although there was finally payment it wasn't the 4k monthly i was promised by insurance

  and will need full payment on rears and the 2 k weekly from this point on as i was sick when i was to make 2000 to 2500 from my 

  job and or jobs if i was able to pull full shifts in between any down time.

  Regards,
  
  ******* *****

  Business response

  06/06/2023

  June 6, 2023 

  Dear *** *****: 
  

  This letter is in response to the follow-up filed by ******* ***** on May 19, 2023 in response to our  complaint response dated April 27, 2023. The complaint follow-up is regarding a claim submitted for coverage  under the above-referenced Non-Participating Group Disability Income insurance policy (“DI Policy”)  underwritten by *******. *** ***** alleges that ******* did not pay all benefits due. To the contrary,  ******* properly paid all claims in full.  
  Policy Information 
  *** ***** is a Certificateholder under a DI Policy issued to ******** ******* *********** (“***”). Copies of  the Policy and Certificate of Insurance are attached for your reference. The effective date for the DI policy was  October 1, 2020. Loomis is a third-party administrator for *******. Loomis relies on its vendor for eligibility  data for Certificateholders of group. 
  Policy Benefits and Claim Payments 
  Policy Benefits 
  *** ***** seeks payment under the Disability Income benefit of the DI Policy for loss of work due to vision  loss. As explained in our April 27, 2023 letter, attached, the DI Policy provides a maximum disability benefit  per Insured per month of 60% of the Insured’s compensation, with a maximum amount of $4,000 per month for  a maximum of 6 months per policy period. There is a 30 day waiting period from when the claim is submitted  to the first benefit payment. The relevant Benefit Schedule excerpt is below:
  
  Disability Income Submission Process 
  As discussed in our April 27, 2023 letter, claims submitted under the DI Policy cannot be processed and paid  until we receive a completed Disability Claim Form (the “Claim Form”). *** ***** submitted his claim on  November 3, 2022, but failed to provide a completed Claim Form including his physician’s attestation of  disability until December 1, 2022. Upon receipt of the completed Claim Form, *** ***** began receiving  payments in a timely manner. The payments were paid per the maximum disability benefit and maximum  covered percent of compensation. 
  Claim Payments 
  As stated above and in the DI policy, the maximum benefit amount is 60% of *** *****’s compensation.  Calculations were based on the information he wrote on the Claim Form. *** ***** wrote on the claim form  that his annual salary is $60,000. The calculation for his monthly benefit of three thousand dollars is as follows:  $60,000 x 0.60 = $36,000 per year. $36,000 / 12 months = $3,000 per month.  
  On the Claim Form *** ***** stated that his date last worked was October 20, 2022. Based on the elimination period, he was entitled to benefits beginning on November 15, 2022. Given the delay in receiving *** *****’s  Claim Form, the waiting period had elapsed, so we began issuing payments immediately. *** ***** will  continue to receive these payments until the maximum benefit period of six months is reached.  
  *** ***** alleges in his complaint follow-up that he is entitled to payments in arrears. As outlined in the  payment chart below, which was included in our prior letter, while the benefit payments were delayed due the  Claim Form submission, the payments account for his original date of injury. The maximum benefit period will  be calculated from the November 15, 2022, the first date the waiting period elapsed, rather than the first date a payment was issued. Furthermore, the DI Policy does not provide for payments in arrears as it only provides  benefits per the Benefit Schedule.  
  As seen in the chart below, all payments due to *** ***** under the DI Policy were paid.  

  Conclusion 
  As outlined above in our previous correspondence, ******* properly paid all claim amounts due to *** ***** in  a timely manner. *** *****’s claim processing and payment was delayed due to an incomplete claims  submission which ******* and its TPA worked tirelessly to correct.  
  Please contact me directly if you have any further questions or concerns. 
  

  Respectfully, 
  

  Sr. Director and Associate General Counsel 
  Globe Life Benefits 

  Customer response

  06/06/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  

  I am rejecting this response because:
  Cannot open files that probably does not prove the fact I was underpaid due to when I signed up true north has sold me a program that pays 4K monthly if I was not able to drive trucks anymore , reasons why I could not get a constant work sced was due to Covid , the the fall of the industry and lost important my health 
  
  Regards,
  
  ******* *****

  Business response

  06/16/2023

  June 14, 2023

  Dear *** *****: 
  As you have requested, please find enclosed our responses to your BBB complaint. 
  Please contact me directly if you have any further questions or concerns. 
  Respectfully, 
  
  

  Customer response

  06/16/2023

  [To assist us in bringing this matter to a close, you must give us a reason why you are rejecting the response. If no reason is received your complaint will be closed as Answered]
  
   Complaint: ********
  
  I am rejecting this response because:
  
  Company was making multiple mistakes and Tried to fraudulently get out of paying for my disability to drive trucks , they have lost paperwork and never did match up to what I was told when I purchased the insurance 

  i Have lost a lot of time and money due to this under paying missing the 4K monthly 

  and will be retaining a lawyer soon if not fixed for damages and not able to survive 

  Regards,
  
  ******* *****

• Initial Complaint

  10/04/2022

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This company is failed repeatedly to process my medical claims and apply the deductible to my account. After involving our head of HR they have supposedly "found" the issue with the system and are "diligently" working on resolving it. A month later there has still be no resolution and they still show my out of pocket paid as $0. This company appears to be completely unable to process simple claims - which is supposed to be their area of expertise. Not only that, but when my provider reached out to them they were given inaccurate information. When I reached out I was also given wrong info and when I argued with them they finally looked at my plan and realized they were not giving correct info. Why would they not look at my plan before answering questions from the provider or from me? Again, isn't this their area of expertise? This company is extremely inept.

  Business response

  04/24/2023

  April 21, 2023

  To Whom It May Concern:
  
  The ***** ******** ********** health care plan is an ERISA self-funded group health plan and therefore does not have an NAIC number.  This plan is a non-grandfathered Self-Funded Medical, Prescription, Dental and Vision plan.  The Loomis Company is a third party administrator contracted to adjudicate claims in accordance with the terms of the Plan.  
  
  PLAN NAME & ADMINISTRATOR:
  ***** ******** ********** Health Care Plan
  EMPLOYER (PLAN SPONSOR) & PLAN ADMINISTRATOR:
  ***** ******** **********
  **** ****** ***
  Everett WA *****
  
  The Loomis Company received an email from the member on 08/11/2022 with copies of claims to be entered and processed so the amounts would accumulate to their deductible.
  Claim was entered as of 08/17/2022 and processed on 08/29/2022 with the charges applying to the member’s deductible. Member emailed on 09/12/2022 asking for an update of these charges. Member was advised claim had processed. Member emailed back advising she was looking for a different claim. Member was advised it would be expedited for her.
  
  There was an issue with the member’s deductible, however there are several steps needed in order to resolve the member’s issues. The issue with the deductible was resolved as of 10/05/2022.
  Thank you, 
  
  ********* ******
  Claims/Customer Service Supervisor 

  Customer response

  04/24/2023

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me. 
  
  Regards,
  
  ******* ******
  

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩