Essential Med Complaint
 SUPPLIER |
Essential Med |
 INDUSTRY |
Insurance |
| BRANCH / AREA | Cape | COUNTRY | South Africa |
| TIME / DATE | 21:27 Wed 2 Nov | PERSON RESPONSIBLE | |
| CUSTOMER | Deeluv | View all reports by user |
 1
5
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| PROBLEM | claims |
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| INCIDENT | Wed 2 Nov | ||
| HEADLINE | hospital plan & stuck with hospital BILLS |
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I have the boost option with essential med and just want to firstly say Marlize and Elize were amazing in assisting me. Marilize is always patient and amazing with me as a client. I will put an official compliment on hello peter for her excellent service. Please whatever you do don't have Nicolene contact me, don't want to speak to her. Our last conversation she was not helpful very defensive. I was involved in a car accident and the following me and my 2 years old baby had to go to the hospital as we both suffered from whiplash. I called and received hospital authorization as this was an emergency I went to casualty. I paid for my medication and x-rays which I was refunded for with help from Marilize and Elize. Jo-ann from claims department asked me to email her statements from hospital and also signed a form to give Essential Med authorization to make payments on my behalf, when I asked on several occasions her response was "we received your forms on numerous occassions" is that an answer? Is that Essential Med's standard response to client, not very professional nor impressive. now I'm still stuck with the bills. I'm told I have to pay the bills and claim back but I have |
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| SUPPLIER'S RESPONSE | Essential Med | Time and Date | 16:37:33 | Tue 8 Nov 11 |
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Hello Deeluv, Thank you for your compliments about the service received from Marilize and Elize - we value your feedback. We have looked into the matter raised and can report the following: We received a reimbursement claim form dated 22 September for a casualty visit following an accident on 13 September 2011. An amount of R808.40 was paid out to you on 14 October, which was well within our stated 30-day turnaround time for the payment of claims. On 4 October, Joanne requested the hospital claim form and received an account for a tonsillectomy, which was not related to the accident of 13 September. On 5 November, Nicolene again emailed a hospital claim form and requested that you complete and return it to us with any additional accounts for this particular accident event. On 7 November, we received the hospital claim form and you again submitted a claim for a tonsillectomy, as well as high fever, both of which do not relate to the accident event of 13 September. We contacted you again on 7 November, requesting the relevant documentation. We will gladly process your claims, but can only do so on receipt of the correct documentation. Kind regards Lee Rodgers Chief Operating Officer |
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