KL
Kerry L

1 reviews | Active since Oct 2013

27 Sept 2017, 07:14

Still no word

It has been almost 1 week with no word from Affinity Health regarding the non-payment of our hospital bill.

Here is a short summary of what happened:

My partner and I joined Affinity Health just less than a year ago, thinking it would be a great option for us due to affordability. She recently went for an operation, for which we had to pay in a large sum of money beforehand. Prior to the op, we received email confirmation from Affinity Health confirming that they would be paying a total of R19 000. The hospital also received a confirmation of payment from Affinity Health for R19 000. Yesterday, my partner received a call, saying that Affinity Health would now only cover R14 000, which totally contradicts the email confirmation which we received.

I received a message from the hospital yesterday, telling us that we are responsible for the outstanding amount and that it needs to be paid asap. This all forms part of the amount that Affinity Health guaranteed that they would pay. Paying the hospital an additional 10k was NOT in my budget. I already paid in R8 800 prior to the op, because Affinity Health wouldnt cover the full amount. What is the point of having medical insurance when they pay for as little as they can get away with??

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Replies (1)
Affinity Health
Affinity Health's reply27 Sept 2017, 08:26
Official

Good day Ms Laasen

Thank you for sharing your concerns with us.

Please be advised that the initial guarantee of payment issued was with respect to the proposed plan of treatment submitted by the doctors, who proposed an initial hospital stay of three days. It has been confirmed that since your partner was admitted in hospital for a duration of 2 days, full benefit pertaining to the days spent in admission was paid out according to the Daily Illness Benefit, and all shortfalls are liable to you as stated in policy wording issued upon inception of your policy.

Kind regards

Affinity Health