Review of Seven Corners, Inc.

3 years ago

Never Go for it

Never Go for it

My Experience with Seven Corners.

Guys, Just thought of sharing my experience with Seven Corners Medical Insurance and Claims. Its a bit long story but I suggest you read before taking policies from Seven Corners for your parents who is visiting you short term in US.
I took an Inbound guest policy from Seven Corners for my parents during their visit to US (the policy was worth $45000). It costed around $410 to buy the policy (for 4 people for 2 months. July 6 2016 to Sep 7 2016). Unfortunately on Sep 02 2016 my father fell down unconscious in the bathroom and his head hit on the tub. Immediately I took him to the hospital emergency. Since he had no medical history and never had any medical issues before, hospital wanted to do some tests and they need to observe him for 24 hrs since he was perfectly alright until that point. So we spend 24 hrs in the hospital under observation and came back home next day.Since seven corners needs us to report the incident within 48 hrs of the incident, I called them on the day my father admitted to hospital on Sep 02 2016. At that time the agent remind me that I have to process the claim within 90 days after reporting the claim.

I have given the policy details to the hospital so that they can submit the bills directly to Seven Corners. and I have been calling the hospital from the first week itself to push them to send the bills to Seven corners as soon as possible. As soon as the hospital processed the bills they send it to Seven Corners for claim. The total amount was around $33568.
In couple of days I received a rejected notice from Seven corners saying that the claim is denied because they need additional information. Here are the details they asked. 1. Passport copy including entry/exit date stamps to establish eligibility, 2. Patient to submit a complete accidental/illness proof of loss form, 3. Claim pending receipt of medical records from another provider. In general they need passport copy, proof of loss form (which we will get from seven corners) and the medical report from the hospital (detailed medical report on what was done).
Then I called hospital and asked them to send the medical report to Seven corners. Also sent the remaining required documents to Seven corners. Then I called seven corners and confirmed that they received all the necessary details. They said the claim would take couple of weeks to verify and process.

After couple of weeks I received another Explanation of benefits notice from Seven Corners with details of the claim. Here is how it goes. The total claim amount what the hospital send was $35568. The document what Seven Corners send to me mentioned the total member responsibility was $3507.00 and Amount paid was $1555.00.
At first look I thought I just need to pay $3507 as that is the member responsibility shown in the document. But later hospital send me an unpaid bill of around $32013 saying that they just received amount $1555 from insurance and member need to pay the rest.

Then we called the insurance and asked why there is a discrepancy in the amounts mentioned in the document and what is mentioned as the member responsibility in the document. They said they made a mistake in the document send to me originally. As per the policy they can pay only a maximum of $1555 for that particular day . That was surprising to me as I was expecting the policy was for $45000 and at least an 80% should have covered by the insurance. Also the Seven corners agent said the policy have a daily limit. For example for Hospital Room & Board Including Laboratory Tests, X-rays, Prescription Medical and other miscellaneous they would only pay $1260 per day and for a maximum of 30 days. That was disappointing as our case was an emergency situation.
Now I don't know how we are going to pay the $32013, my father cannot pay it, he didn't even have a job. Also I cannot pay this amount even with my one year salary :-( !!!

So guys I don't recommend Serven Corners if you are really looking for a policy that would cover emergencies like what mentioned above.