Affinity Lack of assistance and empathy

To Whom It May Concern,

I am writing to express my profound disappointment and frustration with the recent experience my mother, Lorraine Deporah Candy, endured in her time of dire medical need as an Affinity Health Medical Insurance member.

On the evening of Wednesday, 18th October 2023, at 9:00 PM, my mother suffered a severe heart attack. Swift action was taken, and she was transported to Melomedi Tokai after being stabilized by CMR. However, upon her arrival at the hospital, we were informed of the immediate need for substantial upfront fees to admit her and establish her care. To our shock, we were told that the admission fee alone amounted to a staggering R120,000, excluding any specialist consultations, diagnostic procedures, or treatments.

I promptly contacted Affinity Health, as my mother was in no condition to make the call herself. It was at this point that our ordeal took a distressing turn. The operator insisted on speaking directly to my mother, despite my explanation of her critical health condition at the time. She proceeded to subject my mother to an unnecessary series of security questions, delaying any potential assistance. This entire interaction left us bewildered and appalled.

The operator, inexcusably, claimed that this heart attack was a result of a preexisting condition. I must strongly emphasize that my mother, Lorraine, has never suffered a heart attack in the past. While she does have a history of high blood pressure, there is no previous heart attack to be found in her medical records. The lack of compassion and assistance during this traumatic experience was not only disappointing but wholly unacceptable. But especially insisting to speak to her and ask her security questions when the operator already knew she could not be assisted.

I hereby demand immediate access to the recording of the operator's call on Wednesday evening, along with a thorough explanation as to why my mother's claim was rejected. Furthermore, there are pending claims on her profile that have not been settled FULL as promised. I require detailed information and resolution on these claims without any further delay.

I also urgently request a consent form to be sent to my and my mothers email address to act on my mother's behalf, as she is currently incapacitated. I firmly instruct you not to contact her directly, as her health condition renders her incapable of dealing with your incompetence and lack of empathy during her time of need.

For a prompt response and resolution, you may contact me at ***.

This situation demands immediate attention and rectification. I trust that Affinity Health will take swift and compassionate action to address these concerns and restore our faith in your service.

Sincerely,

Taylor Candy-Marais ***

Good day Taylor Candy-Marais,

Thank you for contacting us.

As per POPIA, unfortunately we cannot disclose any policy information to any third party, you are welcome to inform the main member on the policy to contact us directly for further assistance.

Thank you.

It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods.

Should you require any further assistance, please feel free to contact us on ***or reply to me directly.

You are welcome to contact us on any of our other platforms: Whatsapp - *** Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu

Taylor Candy-Marais <***> 10:13 (2 hours ago) to Affinity

I sent you the consent form so I reiterate, I want answers

Good day Taylor Candy-Marais,

Thank you for contacting us.

The consent form provided does not override the Protection Of Personal Information therefore we still cannot disclose any information to any third party.

Thank you.

It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods.

Should you require any further assistance, please feel free to contact us on ***or reply to me directly.

You are welcome to contact us on any of our other platforms: Whatsapp - *** Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu

Taylor Candy-Marais <***> 10:21 (1 hour ago) to Affinity

What do you need then, she cannot act in her own capacity so your lack of assistance is again shocking. I want someone to contact me on a resolution before I take this further

Taylor Candy-Marais <***> 10:22 (1 hour ago) to Affinity

If i cannot act on her behalf and she cannot act on her behalf then what are my options?????

What exactly do you expect me to do? And isn't the whole point of the consent form for this exact reason? this is seriously unacceptable!