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Tonawanda man says insurance company owes him more than $5,000

Posted at 1:26 PM, Feb 09, 2023
and last updated 2023-04-18 18:27:06-04

7 Problem Solvers did a follow up with Plinzke in April, after the original story aired, and with the help of the Attorney General's Office he got his $5,065 back.

A Tonawanda man says a company he thought was providing him with medical coverage owes him more than $5,000.

When a hip injury led Jim Plinzke to retirement, he looked for a new medical insurance plan.

After filling out an online form, Plinzke got a call from a company offering him coverage for $800 less than what he had been paying monthly.

"They said if I paid in advance it would be less than $500 dollars per month, but I'd have to pay an initiation fee or something like that," said Plinzke.

Plinzke paid $5,065 to Quick Health for what he was told was a full year of medical and dental coverage.

"At that time I thought it was legitimate. It made sense to me," he said.

But Plinzke soon learned his doctors were unfamiliar with the ID cards emailed to him.

"When I called and asked them about that, they said not everything is online yet and this is pretty new," Plinzke said.

Plinzke decided to cancel his plan and requested his money back.

"Gentleman told me it was going to take 7-10 days and I said I'm getting a little nervous," he said.

Weeks passed without a refund, so he contacted 7 Problem Solvers.

7 Problem Solver Michael Schwartz called First Health Network, a company on one of the ID cards. A representative said they are just a health coverage network, not an insurance company.

Schwartz then contacted Quick Health. After explaining the situation, he was hung up on. He called back and was told they don’t have the authorization to speak to him and couldn't forward him to a manager.

In the fine print of a receipt, it said the program is not an insurance policy. It provides discounts at certain healthcare providers for medical services.

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"Generally speaking, if you think you're going to get some type of a deal in medical insurance, there’s going to be some exclusions in the policy, things that aren't covered, and a program you probably won't benefit from," said Brian Murphy, a partner at Lawley Insurance in Buffalo.

Murphy provided the following tips for medical coverage:

  • Stick with an in-state insurance company.
  • Go to a company or service where you can sit down with someone and look at options including Medicare advantage programs.
  • Avoid 1800 numbers.
  • Talk to your doctor to see if they will accept the coverage.

Plinzke has contacted his credit card company to dispute the charges.

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