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madskoen M

1 reviews | Active since Jul 2016

30 Nov 2017, 23:12

GAP cover not wanting to pay for co-payment IN HOSPITAL!!

I had a c-section on 21 September 2017 and had to pay a co-payment (booking fee) for the labour. As stated in African Unity's contract, they do cover the booking fee for labour.

I have submitted the claim months ago and since this company is dragging out the claim, coming up with DIFFERENT excuses to pay every time. What is worse, when they sent me an email stating why they reject the claim and I respond to the email with MORE proof, they take 3-4 weeks to reply and each and every time it's just a DIFFERENT excuse why there's a problem with the claim. They have no continuity with their claims and are very quick to take my money each month but reluctant to pay claims when it is their turn to obey their contract!

I had to pay the co-payment from my credit card, and your negligence is costing me money as I have to pay interest for every month you are dragging out this claim!!!

In 2016 I also had a baby and a c-section and submitted a claim for the co-payment (from exactly the same doctor!) with exactly the same account and codes as this one - and it was paid without any problems!!!!! What is the problem this time????? It seems they are not consistent\trained properly as they treat THE SAME CLAIM different in 2016 and 2017.

This is unacceptable as African Unity is *****ing my monthly premium as they deliver NO SERVICE!!!!!

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