Principal Financial Group/Dental Insurance Complaint - Principal Financial Improperly Denies Ins Coverage On Basis Of Covert Policy Termination Date
DES OINS, IOWA -- I retired March 31, 2010. My former employer kindly permitted me to continue existing health and dental insurance policies at my own expense until 9.1.11 when I will turn 65.
Dental insurance was through Principal Financial Group (P). P was fully advised of my retirement status. However, at no time did P inform either my former employer or me of its intention to terminate my insurance coverage on March 31, 2011 (or at any other time).
Here's my complaint. Having failed to disclose an (apparently covert and) impending termination of coverage, P knowingly delayed processing my request for payment predetermination of (clearly covered) dental procedures until it was able to deny coverage on the ground the policy had been terminated. In other words, P sought to escape paying its fair share of a clearly covered dental procedure by figuratively scratching its head and shuffling its feet for nearly 2 months before jumping up and shouting "GOTCHA."
Where I'm from that behavior is often described as lying in the weeds. It's not conduct one expects of a company that promotes itself as ethical and relies on the good will of its customers.
Here's what happened. February 8, 2011, my dentist's office submitted to P a full and complete predetermination request for replacement of failed abutment fixtures and crowns for 2 dental implants that were almost 15 years old. Principal waited almost a month, until March 4, before requesting extensive additional information. My dentist's office promptly supplied the additional information, while privately noting the request seemed a bit out of the ordinary.
My dentist's office advises that approximately a week later (this would have been toward the middle of March), Principal submitted yet ANOTHER request for further information. (By then shaking its collective head), my dentist's office supplied the further information requested. Principal says it received this information in April.
In late April I received from P a denial of coverage based upon an asserted policy termination date of March 31. Totally surprised, I asked my former employer whether it had been advised of the March 31 (or any other) policy termination date. It had not.
I immediately filed with P a written request for reconsideration based on the company’s delayed handling of my request and its failure to disclose its intention to terminate my policy.
No reply. I phoned the company perhaps 10 days later. A representative told me no one would respond to my inquiry “because the policy is terminated.” HUH??
I then filed a request for assistance and reconsideration through the Principal Financial Group website. Several weeks later, I received a reply letter.
The letter denied P had made a second request for information. It altogether failed to address the company’s failure to disclose its impending, seemingly covert policy termination date. It found “unfortunate that your predetermination wasn’t filed to allow ample time to receive any information necessary for review,” and asserted, “We strive to process all correspondence in an accurate and timely manner.” In other words, “Piss off.”
I don't know whether P had a legal obligation to disclose the policy termination date, but it certainly had an ethical obligation to do so. I don’t know whether, under the circumstances, seriatim requests for arguably unnecessary information over the course of more than 2 months constitutes unconscionable stalling, but even my mild mannered and eminently fair dentist found it disingenuous and more than a bit untoward.
Whether or not Principal Financial crossed any legal lines in this matter, to me one thing seems absolutely clear. A company that callously advances its financial interests over those of its own clients in matters of relative monetary insignificance such as this one is not a company I would ever trust to manage my current finances or the future security of my family. Simply a word, I should hope, to the wise.