ComplaintsforGuardian Life Insurance Co. of America

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Initial Complaint
10/21/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I had a dental policy with Guardian Insurance via my employer. I had started a dental treatment including tooth extractions in order to have implants placed. During the process, my employment was terminated which made me lose my coverage. I personally called Guardian to see if they can reinstate my policy to continue treatment and the agent had confirmed it was possible if I had my employer policy for a specific duration which was verified and confirmed. I said I needed to have a guarantee of continuation of services hence the reason I was staying with Guardian. I was told yes it could be done and that since I am in treatment they also waived off my waiting period after verification on old policy. Now, as my treatment continues my dentist office sent in a claim and Guardian denied it because my extractions were done prior to the individual policy. It is unfair to me and I was falsely sold a policy and lied to. I have called multiple times with no answers nor verifications of my recordings. I have also attempted to speak to a manager or supervisor and they said they have sent the request for someone to call me back as per their policy and it has been close to 2 weeks and no one has ever contacted me. This may become legal due to lack of assistance and false claims when policy was sold. Very unprofessional. Claim ***********
Business response
10/23/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
10/23/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because: I would like to have an immediate proper response.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

****-***** **********
Initial Complaint
10/17/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
Dear BBB,A valid insurance claim for my daughter's braces (Dental Code *****) was processed as "Benefits are based on the use of a Non-Contracted Dentist." This is clearly incorrect but a claims specialist thinks otherwise and will not correctly reprocess the claim as in-network. When I asked why he said "because you are asking too many questions" in a telephonic conversation on 10/16/******* Insurance ID for ******************** Dental is: ********** Plan number: ********** (1) The orthodontist (practicing at the specific address/office) is clearly listed on Guardian's own website as in-network and accepting my insurance (SPECIFICALLY: "DentalGuard Preferred")************************************************************************* (a time-stamped PDF copy is also preserved)(2) The Dentist Practice lists that it accepts the insurance on its website:******************************************************(3) I confirmed with Guardian Dental that the doctor, Dr. ****** ***, is "in-network" prior to making the appointment.(4) ********** website indicates that our plan is Guardian Dental Guard Preferred. A fee schedule for different dental procedures is provided as a PDF (as noted above D8080 is the procedure my daughter is being treated for aka "braces").****************************************************************** schedule: *************************************************************************************** (5) I made a subsequent telephone call to Guardian on 10/16/2024 after my 27-minute discussion with the claims specialist "***** ****" (call ended at 9:33am) who said my claim could not be reprocessed because "you ask too many questions." At 9:58am I made a call to customer ********************** to verify that my dentist is in the network and "*****" and after confirming Dr. ****** ***** name, zip code, and address at ******************************************* she confirmed that he is in the network.Will provide more info in attachment...
Business response
10/17/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
10/18/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

The business has not made any attempt to contact me and wants to conceal from the BBB and repeat its fraudulent denial of the claim that the ** was a "non-contracted" provider. As an additional piece of evidence, in reviewing my email, I found that on July 15, 2024 a Guardian employee indeed emailed me a provider directory listing, among other doctors, **. ****** *** at the address of ************************************************************************************** as a PPO-DentalGuard Preferred Provider. This stands in contrast to the claims supervisor who said his name was "***** ****" that I contacted who said that **. ****** *** was out of network.
The resolution is simple and straightforward---reimburse **. ****** *** / ABRA Dental at the contracted rate ($4,378) for D8080 procedure since he is listed as a DentalGuard Preferred Provider both currently on Guardian's website directory and in the documentation I was sent on July 15th prior to making the appointment in August.
Thank you kindly,
****** *******

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

****** *******

Business response
10/30/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
11/01/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me and the matter has been resolved.

Sincerely,

****** *******
Initial Complaint
10/11/2024
Complaint Type:
Sales and Advertising Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Guardian's dental insurance says that dental cleanings are covered 100% whether it is an in-network or out of network dental office. I had my teeth cleaned, and Guardian only covered ~45% of the charge. They clearly have false advertising and lie to their customers.
Business response
10/11/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
10/14/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

[Your Answer Here]
I can accept they are working on this and will follow up with me. I dont want this case closed, so I had to reject the response. It shouldnt be hard for Guardian to look and see they claim to cover 100% of my dental cleaning, and they only covered 45%

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

***** ******

Business response
10/25/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
10/29/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

[Your Answer Here]

Guardian got back to me, but didnt address their false advertising within their own app. They push the burden of responsibility back on me to reach out to them to see what is covered. I am their customer, not the other way around. Why would I reach out to see what is covered, when right in your app, you tell me a cleaning is covered 100% whether in or out of network. They dont address me as a valued person, but rather just throw out some copy and paste insurance jargon and refuse to cover a common cleaning. Because they refuse to cover this dental cleaning, I will look to leave Guardian as soon as open enrollment comes in 2025. However, I want this false advertising claim on the record to hopefully prevent future clients from enrolling with Guardian as an insurance provider.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

***** ******
Initial Complaint
10/08/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
On August 16, 2024, my mother's account was closed (I'm POA). The account was opened as a corporate account (which had been inactive now for over 25 years). A check for $197,115.18 was issued to her in the corporation's name. The check cannot be deposited or cashed as the corporation is inactive. I have called the Guardian REPEATEDLY since August 26th to try and have the check made out to my mother's name. I've spoken with Supervisor ******* ******* who promised several times to call me to let me know what Operations determined about the check. He does not return my calls; neither do Supervisors ****, **** or ******. My mother has lost out on 2 months interest on close to $200,000.00. The check is collecting dust. I also emailed a complaint to the Guardian on September 26th. I got a response stating an advisor would contact me. I haven't heard a word.
Business response
10/10/2024
Good day,
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will direct this complaint to the respective area, and they will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Initial Complaint
09/26/2024
Complaint Type:
Service or Repair Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I am currently on short term disability due to a heart condition as of 6/12/2024. I have received three payments from guardian for July and one payment for August. My last being on the 12th of August for a small total of approx $350. This was not a full release of the dates I was approved for, therefore they shorted that check. All forms and documents that have been needed to process my claims have been faxed and uploaded to the secure web channel. I have called the company five times in just the last two weeks to see why I have not been paid since the 12th, they stated I was missing forms since my claim started in June of 2024. However I have been paid out previously, which would not be possible had they not received all forms of appropriate documentation. My *** has faxed all forms several times even speaking with guardian at one point. They have had contact with my doctors. However they are refusing to release any more payments till that is received. Ive been on the phone going in circles about these forms being received even when the last representative I spoke with said my work stated I needed an extension. My job has also denied my medical accommodations and placed me back on short term till they can find a position. Guardian is not keeping accurate records for their patients which is causing a life crisis.
Business response
10/02/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
10/22/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:
The company since opening my dispute has denied all my claims after 8/16/24 on 10/21/2024. My claim was not reviewed on time within their ten day window for claims of short term disability. All documents were confirmed by my doctors office to have been sent to guardian after each appointment, as I've attached the confirmations. They have caused me not only mental distress but they have caused me financial distress to where I am close to losing my home and vehicle. I was not released from doctors care to return to work until 9/25/2024. Any day before that I was required to be off of work due to my cardiac symptoms and unable to work. Per my doctor and her recommendations she stated I could not work or return until that date. I am owed the payout from 8/17/2024-9/24/2024.

In order for the BBB to appropriately process your response, you MUST answer the question above.

Sincerely,

****** ******

Business response
10/24/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Initial Complaint
09/06/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Canceled husbands policy and Guardian continued to make auto deductions for 9 months totaling ******. After numerous phone calls they refused to make payment. A lawyer was contacted but fees out weight amount owed.A bill then was sent for vision only for myself that was also canceled.
Business response
09/06/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Initial Complaint
09/05/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
I am currently receiving *** from guardian and they sent my account to collections. It doesn't make sense why and they refuse to speak with me about it.
Business response
09/06/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Customer response
09/06/2024
Better Business Bureau:

I have reviewed the response made by the business in reference to complaint ID ********, and am awaiting their response.

Sincerely,

**********************************************
Initial Complaint
08/30/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Guardian has drastically changed their coverage and their peer review doctors seem to always take the side of guardian NOT paying out any money for services they claim to cover.We received dental root scaling treatment after almost 2 years of not going to the dentist and there was definite bone loss but guardian say not enough bone loss for the treatment. It's ridiculous. They want our teeth to be rotten before paying out anything. It's a scam company this year in 2024. In 2022 they were much better with coverage! Same treatments were covered with no issues.
Business response
08/30/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Initial Complaint
08/29/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I have Guardian dental insurance. My plan covers crowns for teeth that cannot be repaired with a routine filling. I had a tooth that was cracked and had existing fillings, and my dentist determined that the only way to repair it was with an onlay. Guardian kept denying the predetermination, and while I appealed and waited, the tooth got worse. It was bothering me, there was more decay, and I wound up needing an emergency appointment and the repair had to be escalated to a full crown. There was no time to wait for another predetermination. My dentist submitted the claim for the crown to Guardian with x-rays, images, and notes. Guardian denied the claim. My dentist submitted an appeal, and the appeal was also denied. The reason Guardian is giving for the denial is they that their reviewing dentist says the tooth couldve been fixed with a routine filling. I called to get information about who this reviewing dentist is and they wont give me any information. They are refusing to pay for a procedure that is covered by my plan. I assume their reviewing dentists are on Guardians payroll and thus have a conflict of interest. I plan to keep appealing, but it is extremely time consuming, and I feel that they will keep coming up with illegitimate reasons to deny the claim.
Business response
08/29/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America
Initial Complaint
08/22/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Hello, I filed a short term disability claim with Guardian on 07/11/24 and as of today am still awaiting payment from them. I have provided all necessary documentation and information to multiple customer ********************** representatives as requested on each of many calls to this company as has my employer and my employers insurance representative through which Guardian provides the service of supplying the *** insurance. I have been told at least 4 times on separate occasions that my case manager will call me directly and that has not happened once. I have not been able to directly speak with my case manager and each call becomes more frustrating as there is never a resolution to my claim. I am well past the 10 day elimination period for the claim to be paid and this has left me without and funds to take care of my expenses while being out of work from a major operation. Hence the point of short term disability. I am beginning to think this is a fraudulent operation and I am extremely upset about this ordeal. I would also like to add that I have given them the correct information to directly contact the HR department of my employer multiple times should any information pertaining to my claim be missed and they have conveniently sent email correspondence to incorrect email addresses which I and my employer have asked them not to do as we have all provided the correct information.
Business response
08/22/2024
Thank you for bringing this matter to our attention. Customer satisfaction is extremely important to us. We will provide a response directly to the complainant.

Sincerely,
The Guardian Life Insurance Company of America

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