Wednesday 17th of October 2018 12:56:36 AM
My mother fell in Sept. 2014 and needed home care when she came home from a nursing home. When I initiated a claim with John Hancock, we were told my mother needed to satisfy a 60-day elimination period before they would cover costs of her care. She had been in a home in 2010 for a previous fall and I was told that her stay in that facility would count toward her elimination days. I was told over and over that this would not be a problem. I had the forms from the nursing home submitted and heard nothing from John Hancock. Meanwhile, my mother has been getting home care services and John Hancock has been using those bills to satisfy the 60 days, which means my mother would have to pay out of pocket for this in the amount of about $2000.00. About a month ago, I received a note saying they would not consider any days before Sept. 2014 for the elimination period. When I called to ask about this, I have been told several stories. One said that when the nurse visited my mother for an initial evaluation, no one mentioned the first nursing home. Then I was told that they would send the request to use these days to specialists to review. Today I was told that it is their policy not to review anything before 360 days prior to a claim being made. This information is not in the policy, it's an internal rule. When I asked the supervisor why after all the phone calls, no one ever told me this until now, she couldn't answer me. When I asked why I was told specialists would review these bills when in fact this wasn't true because she was telling me about this internal rule, she could not answer that either. When I asked why after months of phone calls, I was first hearing about this internal rule, she went to find a manager and left me on hold for fifteen minutes only to return to tell me no one was available. If the company has an internal rule, why would they not say anything? We could have left her in the nursing home and had Medicare cover this for many more days, but we felt it was better for her to be home and we had insurance after all. They are either criminals or the most incompetent company around. Stay away from them if you can.