February 5, 2011
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Subject . Golden Rule Insurance Co
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To whom it may concern @ WWBT 12 on your side,
When I turned 50 years old in 2001, I went to Dr. Sanjeev K. Jairth with the Richmond Gastroenterology Associates for my first colonoscopy. One colon polyp was found, tested, and found to be benign. At that time I was told by Dr. Jairth to come back in three years as colon polyps are not unusual, but would rather be safe than sorry.
In March of 2002,without my knowledge or consent, Golden Rule added a rider-amendment that suspended coverage of my ileum, colon, and rectum.
At 53 years of age in 2004, I received my second colonoscopy. There were no polyps. Dr. Jairth said he would see me in five years. At this time, had I known Golden Rule had suspended my colon coverage, I would have appealed their decision based on the clean colonoscopy and the three year time span since my last colonoscopy.
In April of 2010, I had my third colonoscopy. Just below the splenic flexure a 4-5 cm mass was seen. This was biopsied and submitted for histology. I was told I needed surgery and set up to have it at John Randolph Hospital in Hopewell Va. Upon reflection I decided to have the surgery at St. Marys in Richmond. I called Golden Rule to inform them of the surgery location change and was told at that time my surgery would not be covered! As you can imagine my surprise and confusion at the news. Not only did I find out I had cancer but the coverage I had been paying $16,000.00 per year for was denied.
I had the surgery in April and all went well. No chemo was necessary and I was out of the hospital in a couple of days and back in rare form a few of week later. I feel fine except for the bills. We have been trying to pay them ourselves. We appealed the Golden Rule ruling but was denied again..
In closing, I do not want anything that is not mine. I paid for the coverage and expected it to be there when I needed it. Over the last few years the premiums have been going up every few months. Being self employed in the home building industry, with this economy, to say the least, has been very difficult. Any help you can give us would be greatly appreciated.
Sincerely,
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