1 reviews | Active since Nov 2009
Do not expect your claim to be paid any excuse
I have been a customer of Complimed/ Ambledown since 2011. <br> I submitted a claim 15.01.2016. With no response.<br> I again emailed and requested a response on 05.02.2016 - still no feedback.<br> Call and spoke to Deirdre Van Den Berg and was told there is a possible rejection due to a waiting period for spinal surgery. <br> Received the rejection on the 11.02.2016 to which I responded with proof of membership since 2011,<br> Then I am told we are investigating. <br> PERIOD OF INSURANCE: a. From 1 January 2015 to 31 December 2015 (both days inclusive).<br> b. Plus any subsequent period for which the company agrees to accept a renewal premium.<br> <br> ORIGINAL INCEPTION DATE: 1 October 2011<br> <br> Rejected 2*** = 4 yrs really hard maths<br> No benefit shall be payable during the first 12 months of<br> becoming an Insured Person, for a claim relating to the<br> following procedures or surgery:<br> - Joint replacement surgery or joint arthroplasty<br> - Scopes<br> - Spinal Surgery<br> I have reported them to the Ombudsmen. But wish to alert the public of the total disregard this company has for it's customers. And the fact that I am now being hounded for payment by the Drs.<br> <br> Service what service - why do I have the cover
We thank you for the above complaint and a detailed response is sent to the policyholders email as promised in the various correspondences already exchanged with you.
Our records indicate that since 2013, your family has submitted 6 (six) claims and 5 (five) were paid, except the last one that you are disputing.
Therefore the message that you are sending with your subject to this complaint is misplaced.
In the second page of the letter you are quoting above, we outline a dispute process that you should follow regarding the review of your claim. Referring your matter to the Ombudsman is the last resort. We would appreciate if you can follow that process.
We will follow our processes and respond accordingly including co-operating with the Ombudsman as and when we receive the complaint.
Thanks and Kind regards,
Paul Makwea
Risk and Compliance Department
Ambledown Financial Services (Pty) Limited
We thank you for the above complaint and a detailed response is sent to the policyholders email as promised in the various correspondences already exchanged with you.
Our records indicate that since 2013, your family has submitted 6 (six) claims and 5 (five) were paid, except the last one that you are disputing.
Therefore the message that you are sending with your subject to this complaint is misplaced.
In the second page of the letter you are quoting above, we outline a dispute process that you should follow regarding the review of your claim. Referring your matter to the Ombudsman is the last resort. We would appreciate if you can follow that process.
We will follow our processes and respond accordingly including co-operating with the Ombudsman as and when we receive the complaint.
Thanks and Kind regards,
Paul Makwea
Risk and Compliance Department
Ambledown Financial Services (Pty) Limited