Illinois Dental insurer keeps losing claim submissions

D

Dan C

New Member
Jurisdiction
Illinois
Hello,
My wife's employer offers a dental plan administered by MetLife via Education Benefits Cooperative. MetLife keeps losing my wife's submissions faxed and mailed to them multiple times and responds that they "have no record of the claim" in their system despite multiple mailings and faxes. Calls to customer service yield no result. IL Dept. of Insurance claims it is outside of their area, so does Department of Labor. Hiring a lawyer would cost more than the potential recovery amount. What other recourse does my wife have?
Thanks.
 
If your wife worked for my employer, I am the one she would talk about this.

Has she talked to her HR/Benefit department at all? They often have contacts they cannot share with employees, but who can cut through all the nonsense and get things moving.

If she worked for my employer and she called me about this, I would first ask her to put everything that happened, including dates, times and names if she had them, into an email so that I had everything in her own words. Then I would send that information to my contacts, which are available to me but not to the employees. A manager would be cc:d onto the email I sent, and they would follow up with Met Life if they did not respond within 2 business days.

Depending on her employer's relationship with the Met, her mileage may vary. Her HR/Benefits office may have a different procedure. But it's time to bring them into the picture.
 
Has she tried mailing it certified, return receipt requested? Then she'd have proof of delivery and a name of the recipient. I've also accepted information by having someone email it to me while I was still on the phone with them.
 
Other than emailing it and staying on the phone till the recipient gets it, I don't know what more to suggest then, other than to keep pushing on the DOI.
 
This thread is too much like being at work. We changed to Met Life a year and a half ago and have had nothing but complaints.
 

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