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 Essential Med Complaint

SUPPLIER

Essential Med

INDUSTRY Insurance
BRANCH / AREA Cape Town COUNTRY South Africa
TIME / DATE 10:51 Tue 8 Nov PERSON RESPONSIBLE
CUSTOMER fourieandre View all reports by user
PROBLEM

Not Paying Claims

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INCIDENT Tue 8 Nov
HEADLINE

Just like a ****

With all claims there are always some or other excuse not to pay. It seems as if their rules are written for themselves only. Forget to try and communicate with them. Because of a swelling it was decided that this a pre-existing condition, while I have a biopsy report that states it is infection. No thank you for schemes like these. Please people. Don't support this company. They will only take your money and you will get nothing in return.
SUPPLIER'S RESPONSE Essential Med Time and Date 16:30:31 | Tue 8 Nov 11
Hello fourieandre,

We regret to hear about Mrs Fourie's recently diagnosed condition. Unfortunately, in keeping with our policy rules, we are not able to extend our Dread Disease benefit as Mrs Fourie's physician confirmed that the initial symptoms occurred within 90 days of the policy inception date (waiting period) and her condition is thus deemed to be 'pre-existing'.

Waiting periods are not unusual for medical schemes and we disclose these via our policy documentation and our website, for prospective members to view before purchasing medical insurance from us. The information below refers:

7.5.1 If during the Period of Insurance any Insured Person, within the Territorial Limits, is diagnosed as suffering from a Dread Disease, symptoms of which were not present in the Insured Person in the 24 months prior to the inception of the Policy Schedule and which symptoms first manifested after 90 days from the Commencement Date stated in the Policy Schedule, the Insurer agrees to pay the Insured as Compensation the sum stated in the Schedule of Compensation.

We sincerely regret that we are unable to set aside our policy rules in this instance.

Kind regards

Lee Rodgers
Chief Operating Officer
CUSTOMER'S FEEDBACK fourieandre Time and Date 08:11:43 | Fri 11 Nov 11
Utterly Disgusted: Yet more and more excuses

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