Essential Med Complaint
 SUPPLIER |
Essential Med |
 INDUSTRY |
Insurance |
| BRANCH / AREA | Somerset West | COUNTRY | South Africa |
| TIME / DATE | 10:35 Thu 2 Feb | PERSON RESPONSIBLE | |
| CUSTOMER | herman71917 | View all reports by user |
 0
2
|
| PROBLEM | Billing / Accounts |
 Post this report to your Facebook page Post this report to your Twitter page
|
|
| INCIDENT | Thu 2 Feb | ||
| HEADLINE | Refuse to pay Hospital Account |
||
|
Still waiting on reply from Nicolene regarding E-mail sent on 27 Jan 2012 re Pat Bernardo Policy number: 1014447 What a pathetic Medical Insurance company. No protection for Prescribed Minimum Benefits as per the Medical Schemes act. Prescribed Minimum Benefits (PMB) which should include the provision of diagnosis, treatment and care costs for: o Any emergency medical or surgical condition o 26 chronic medical conditions as defined in the Chronic Disease List (CDL) o A further 270 listed medical conditions referred to as diagnosis treatment pairs Be prepared to die when having a heart attack or any other emergency condition while insured with Essential Med. They will not cover your hospital bills (Even State Hospitals are reluctant to admit you if they hear that you are covered by Essential Med - they just don't pay the bills) But don't blame the staff - the stake holders instruct them to decline claims because they might have financial problems or they are fortune seekers |
|||
| SUPPLIER'S RESPONSE | Essential Med | Time and Date | 17:03:43 | Thu 2 Feb 12 |
|
Hello herman71917, We would like to draw your attention to the following: o Essential Med's brand is well-known and our hospital plan is widely accepted, including at leading healthcare group Mediclinic, o the client was refused hospital admission because pre-existing medical conditions were not declared (as is legally required) on her signed application for medical cover; our underwriters have medical reports which reflect that critical medical history was ommitted and will provide same, o despite the client not being entitled to any benefits as a result of the above omission, we facilitated her transport and tried to assist with her hospital admission, o our hospital plan provides medical insurance and not medical aid; the Prescribed Minimum Benefits (PMBs) to which you refer do not apply to medical insurance products, only to medical aid schemes. We clearly indicate that we are not a medical aid scheme on both our website and policy information, where prospective clients may scrutinise our stated benefits prior to joining. We regret that the client's failure to declare critical medical history has contributed to this situation. Kind regards Lee Rodgers Chief Operating Officer |
|||
Relevant content (Last 5 Billing / Accounts Problems)
 |
|||
 |
|||
|
|
|||
|
|
|||
 |
Facebook Application
