TM
Thapelo M

1 reviews | Active since Dec 2019

12 Dec 2019, 13:07

Insensitive and Unreliable - No integrity..., NONE AT ALL

Affinity needs to develop some sense of sensitivity towards its clients. I understand that for an organization that’s driven by profit..., being sensitive is often never a goal; but you guys chose to deal with people’s lives. Try harder to manage your greed. You are responsible for most lives lost..., because of caring more about getting monthly premiums for which you exhaust all your resource to create cases that you feel exempt you from taking responsibility.

My wife has been applying for authorization for the past two weeks..., to go for a stitch since we are pregnant with twins. You requested motivational letters from our gynecologist, which we provided. Then you denied us authorization, claiming that we haven’t served our term. We dismissed that claim... You requested blood tests..., we provided them..., and proved that we are indeed deserving of your aid. Today you come with the most insensitive excuse EVER. You tell us that you can’t authorize our process because we had a miscarriage before. Are you guys for real...? How does that connect with our current situation...? We are having a completely HEALTHY pregnancy. If it was a single pregnancy, the stitch would not have been necessary. The stitch is necessary now because of the weight of a double pregnancy. This is commonly done where there’s double pregnancies as a precaution. The weight of the twins could lead to a premature delivery... What does this have to do with the fact that we lost a child before...? How does this qualify as a pre-existing condition...?

You are failing to serve your clients best because you are incapable of feeling with them..., and you lack tactical approaches. That’s why you were so cold and quick as to remind us of our previous loss..., at a time where we are celebrating a GREAT blessed.

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Replies (6)
Affinity Health
Affinity Health's reply12 Dec 2019, 13:32
Official
Good day Thapelo

Thank you for raising your concerns with us.

We want to extend our sincerest apologies concerning all the issues that you have faced. We pride ourselves in maintaining the highest quality standards for our customers. 

Kindly note that an investigation will be conducted and a Complaints Officer will be in contact with you to provide you with feedback.

Kind Regards
Affinity Health Management Team





TM
Thapelo M's update12 Dec 2019, 14:30
Reviewer Update
Sir/Ma’am..., it’s been 2 weeks that we have been sending documents and countering your great reasons why you deny us coverage..., while you continue to debit money from us... This procedure was scheduled for last Friday... Tomorrow is the next appointment with our gynecologist. This is just not right... Why should there be such a delay where people’s lives are at stake...? Your pre-authorization procedure is clearly not prioritizing people’s lives. That you “pride yourselves in maintaining the highest quality standard for your customers” means NOTHING if your customers continue to raise valid grievances like this on hellopeter... You should know that we don’t just jump to this platform to expose your incompetence and lack of care for us as your customers. There’s already been tiresome efforts from our side to have civil conversations with you off public domains..., to which you respond with such a high level of indifference. It’s frustrating...

What are we to do in this case...? Reschedule again to the next available date with our gynecologist...? It’s holidays... Are you guys waiting until she tells us to come again next year...?
Affinity Health
Affinity Health's reply12 Dec 2019, 14:52
Official
The Complaints Department will need to investigate your case to ascertain what the reason was for authorisation not being granted as each case is based on its own personal merit when request for authorisation is received. Our decisions are consistent and we ensure that it is aligned with treating all customers fairly.

May you please allow for the investigation to proceed and await contact from the relevant Complaint's Officer.

Kind Regards
Affinity Health Management Team
TM
Thapelo M's update19 Dec 2019, 11:13
Reviewer Update
It’s sad how this organization shows no concern for its customers. So you guys really expect us to wait so long while you claim to be doing “investigations”...? How many times must our Gyne keep postponing our procedure..., while we wait for Affinity to do us right...? This is truly shockingly sad and unbelievable...
TM
Thapelo M's update19 Dec 2019, 11:40
Reviewer Update
Are you referring to the same person that told us that if we are not happy with your decision we must contact your complaint center...? Was that your complaint officer...? You guys are wasting our time..., playing games with our lives. Our doctor has been contacting you..., and the hospital as well. Nobody understands why we are denied aid. Your reasons (which I repeated above) do not make any sense; whatsoever... What did you investigate..., all this time...? I repeat..., THERE IS NO CONNECTION BETWEEN US LOSING A CHILD BEFORE and our current procedure. We CURRENTLY expecting TWINS... Were it a single pregnancy we would not be doing this procedure. Don’t you understand that it’s not our previous miscarriage that’s calling for the procedure..., it’s our DOUBLE pregnancy...?
Affinity Health
Affinity Health's reply19 Dec 2019, 11:55
Official
The Complaints Officer is attempting to contact the policyholder to advise once again of what was told to you and your wife on the 12th December 2019.

This is sensitive information, therefore cannot be provided to you on this platform.

Kind Regards
Affinity Health Management Team