Insurance Policy Fails to Provide Peace of Mind: Family

By Lisa Parker and Robin Green
|  Wednesday, Oct 5, 2011  |  Updated 10:34 PM CDT
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Just when she needed them, Arlene Gomoll, 83, says she's gotten the run-around from a long-term supplemental insurance provider she's dealt with since 1993.

Just when she needed them, Arlene Gomoll, 83, says she's gotten the run-around from a long-term supplemental insurance provider she's dealt with since 1993.

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Like clockwork, 83-year old Arlene Gomoll said she has paid her long-term insurance bills on time every month since 1993.

When a fall late last year led to a broken femur, Gomoll said she didn’t worry about hitting her Medicare limit. She knew, she said, her United American supplemental policy would kick in where the government program cut off.

"At that time, I had started my Medicare program. I’m alone, I have no children, and what am I do if I should be in this situation? And I was in a position to pick the insurance up and I’ll have no problem," Gomoll told NBC Chicago. "Or so I thought."

She said she didn’t need the coverage until late last year, when that fall landed her in long-term rehab. Her Medicare coverage capped out in December, which is when she said she turned to United American for the supplemental coverage.

"It's been more than frustrating," she said of her dealings with the company. "It should not be, because they have a contract and they should honor it. I certainly have paid enough money in that time."

But Gomoll told NBC Chicago the company was giving her and her family the runaround, in the form of repeated requests for duplicate information. As her bills climbed into the thousands of dollars, Gomoll said she started to worry that her life’s savings would be wiped out.

Five, six, then seven months passed, and still, she said, United American was asking for more information rather than reimbursing any of her bills.

Her niece and nephew, Wendy and John Gomoll, started trying to help.

"We are frustrated, fed up with the lack of communication," Wendy Gomoll said.

"It was very disappointing that this insurance company withheld benefits from her for nearly seven months, to an 83-year old woman who had religiously paid her premiums for more than 18 years,” said John Gomoll.

When her bills reached the $36,000 mark, Gomoll said she had a tough decision to make. She would run out of money soon, and worried she would have to leave the rehab facility before she was fully healed.

"It’s an expense that I can no longer afford," she said.

Gomoll filed a complaint with the Illinois Department of Insurance, and asked Target 5 to look into her story as well. The Department of Insurance would not confirm if it made calls on Gomoll’s behalf, nor if an investigation into her case was launched. But in August, Gomoll said she finally received a portion of her reimbursement money.

After our interview, she said she subsequently was reimbursed in full. United American decline to comment on this report.

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