Refund Policy

1. Distinction Between Carrier Premiums and Agency Fees

To understand refund eligibility, consumers must distinguish between insurance carrier premiums and direct agency service fees:

2. Health Insurance Premium Refunds & ACA Rescission Rules

• Prior to Coverage Effective Date: If an application is withdrawn, denied by the underwriter, or canceled prior to the effective coverage date, any initial premium binder payment submitted will be reviewed for return or credit in accordance with the issuing carrier’s standard cancellation guidelines.
• After Coverage Effective Date: Once health insurance coverage becomes active, premium refunds are determined solely by the insurance carrier based on active coverage days, earned premium calculations, and statutory termination requirements. Canceling a policy mid-term does not automatically entitle an insured to a prorated or full refund of previously paid premiums.
• Affordable Care Act (ACA) Restrictions: Under federal law (including 42 U.S.C. § 18001 et seq.), health insurance carriers are strictly prohibited from retroactively canceling or rescinding health coverage except in cases involving fraud or intentional misrepresentation of material fact. Retroactive refunds cannot be issued for past coverage periods during which benefits were active and available.

3. Cancellation Procedures & Health Insurance Marketplace Rules

Requests to terminate or cancel health insurance coverage must follow specific administrative channels:

• Direct Carrier Policies: Cancellation requests must be submitted directly to the insurance carrier or through Mally Financial Services in accordance with the carrier’s written termination notice requirements. Cancellation is effective on the date established by the carrier under the policy terms.
• Marketplace Coverage (HealthCare.gov / NY State of Health): Consumers enrolled through a federal or state health insurance exchange must process terminations in accordance with exchange rules. Consumers are strongly advised to confirm the start date of any replacement coverage prior to terminating existing plans to prevent unintended gaps in health insurance.

4. Duplicate, Incorrect, or Unauthorized Transactions

If you believe a billing error, duplicate transaction, or incorrect charge occurred during your interaction with Mally Financial Services, you must notify us immediately.

• Upon receiving written notice, we will investigate the transaction records immediately.
• If the error occurred within our agency processing systems, we will promptly correct the billing entry or issue a refund to the original payment method.
• If the transaction involves an error by an external insurance carrier or third-party payment processor, we will coordinate directly with the entity to assist in resolving the billing discrepancy.

5. Claims and Utilized Benefits

If healthcare services have been rendered, medical claims have been submitted, or benefits have been paid out under a policy, premium adjustments or cancellations cannot create a right to a retroactive refund. Premium calculations for active risk periods remain fully earned by the insurance carrier.

6. Submitting a Refund or Payment Inquiry

To request a payment review or inquire regarding a potential refund, please submit a written request containing:

• Full legal name and primary contact details.
• Policy number, application ID, or reference number.
• Date, amount, and payment method of the transaction in question.
• A clear description of the reason for the request, accompanied by supporting documentation (e.g., bank statement excerpt or carrier cancellation confirmation).

7. Review Timelines and Payment Processing

Approved refunds will be processed using the original method of payment whenever feasible. Refund processing timelines vary depending on the financial institution, payment gateway, or insurance carrier involved (typically requiring 5 to 10 business days following formal approval).

Mally Financial Services is not responsible for processing delays attributable to third-party banking institutions or carrier administrative workflows.

8. Statutory Rights & Consumer Appeals

Nothing in this Refund Policy is intended to limit, modify, or waive any statutory rights, claim appeal procedures, or grievance rights guaranteed to consumers under federal law, the New York State Department of Financial Services (NYDFS), or state insurance regulations.