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Allen N

1 reviews | Active since Oct 2018

23 Oct 2018, 11:16

Ambledown ******

Ambledown Insurance is probably the worst people to deal with regarding claims as they are quick to debit your account but even quicker to repudiate your claim after you have been advised by there very own consultants before even making upfront payments to the Hospital. Grant Harling who is the manager and Tiago De Carvalho (Director) is really useless but train the staff very well to repudiate claims and i am sure the staff is rewarded for making sure a claim is not paid. Ambledown is not the insurance company to be with,be careful of legal theft in our country and with ************ entities and individuals like this.

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Replies (2)
Ambledown
Ambledown's reply23 Oct 2018, 12:33
Official

Dear Allen Naransamy ,

It is with mixed emotions that I respond to this review.

Though we appreciate feedback, it will be highly appreciated if it is constructive and considerate.

Defamation will not be tolerated and it is requested of you to treat us in the same way that you would like us to treat you.

Based on what I could find to now, the claim that you put through was rejected as eligibility conditions on the policy were not met. Copies of the policy document were sent to the nominated email address and we have reason to believe that you are in possession of such.

An insurance policy is a contract which covers the policyholder in the event of certain insured events having taken place. The cover is subject to specific exclusions and terms and conditions which are set out in the policy documents. The onus lies on you to fami****ize yourself with the terms and conditions both at the inception and during the operation of the policy.

In the disclosure section of the policy document and in the last page of the rejection letter, the claim review process is outlined. I challenge you to consult either document and follow the correct process to allow for a review.

I am looking forward to a positive, professional engagement with you in future.

I trust that you will find the above to be sufficient and in order.

Thanks and kind regards,

Paul Makwea

Risk and Compliance | Ambledown Financial Services (Pty) Ltd | FSP 10287

AN
Allen N's update23 Oct 2018, 13:25
Reviewer Update
Hi Paul Makwea Before i booked my daughter in for the procedure i called an Ambledown consultant and explained to him what i needed to claim for and asked what was required for the gap cover claim,why was i not told at that time my claim would not be paid for (unprofessional).When i eventually send the claim through i got a automatic reply stating my claim will be sorted out in 2 weeks time and nothing happened(misleading).I eventually phoned after 4 weeks and was told that my documents had not been received and i should re send it which i patiently did and got another automatic 2 week reply,another two weeks past by and i was once again told that my receipt was insufficient and i must now send a detailed hospital report which i again sent through and i was in all this time never told that my claim would not be paid.My claim was eventually repudiated after another 2 weeks when Ambledown staff and management found a loophole that could be used in order to not pay out.Paul Makwea,you must realize that your policy wording states your my daughter is dependent on you and not if she is employed, this was a way for Ambledown to finally find a loophole and repudiate the claim,i should have been told from the time i put her on the policy and if not then then from the time i started the claim,wouldn't anyone including staff at Ambledown be upset if this had to happen to them ? Finally i agree that i would like to also be treated in the same respectful and honest way as you would like to be treated.