PJP Health Agency

PJP Health Agency is a scam. I would love to see a class action lawsuit against this company for their refusal to pay claims. Internet

14th of May, 2011 by User774939

I took out a policy with PJP Health Agency because the agent said it had great mental health coverage, that included Attention Deficit Disorder, which I thought that I had. I went to a psychiatrist to have an ADD screening. As soon as I start receiving care and medication for it, they changed their tune on everything. My doctor had been trying to receive payment for my initial visit for 3 months, they said they wouldn't pay it because they believed it was a pre-existing condition, and they told my doctor that. When I called, they said that nothing to that effect was written in my file, and there were no notes that said anything about that. So I went to my doctor and I paid her out of pocket (and had been paying for all of my prescriptions out of pocket as well) and I had never received a single benefit...EVER. I called again and I was assured that everything was fine and that they should file the claim again. It went back and forth for a couple of weeks. They still denied the claim. When I called, they told me that 'they don't recognize ADD as a condition in adults' and that it was stated in my policy packet. With this policy, they never even send you a paper packet in the mail. It's all on their website and you access it with your policy number. There is no way for you to really know if you're looking at the same information the agent went over when you originally took out the policy, so it's easy for them to change it and back it up. Call me paranoid, but it's a bit unsettling. They also told me that if I had symptoms of ADD in the past, even if I wasn't diagnosed with it, that it would be viewed as pre-existing and it would not be covered. I canceled my policy with them, but they made sure to take out their next payment before they canceled it, even though I asked them to cancel it before the date that they deducted it from my bank account. I would be very cautious if you ever decide to take out a policy with them. Actually, I just wouldn't take one out as they make every excuse not to pay claims.

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