1 reviews | Active since Feb 2018
False advertising - misleading
I recently had a cesarean and my gynae charged substantially more than my medical scheme tariff. I thought I was cover though as my gap cover would pay up to a max of 5 times my medical scheme tariff. I was wrong! Though I must admit Ambledown were very quick in making the claim payment I was however surprised that it was not the amount I thought I was going to get. I was under the impression that Ambledown would payout 5 times my medical scheme rate as is specified on their website http://www.ambledown.co.za/gap-products/gap-products.html. Stating : "Gap Cover 100 provides for charges... Limited to 5 times the medical scheme tariff " my understanding of this is that eg. Your medical scheme rate is R100, Ambledown will pay a max of 5 x 100 =R500. This is apparently not the case, turns out that they pay to a max of 5 times medical scheme tariff less the medical scheme tariff (definitely not the wording used on the website) So basically Ambledown only pay you a max of 4 times (400%} MS tariff and not 5 times. Please Ambledown stop misleading us consumers. Here I was expecting a payout of 500% instead only 400%. Thanks
Dear Ms Esterhuizen,
Thank you for your note and compliments on the claims process.
Your policy has been active for just over a year and you had 3 paid claims to date.
It is of concern when you question policy benefits at (3rd) claims stage and part of your claim is not covered.
Please engage with your broker to understand the function of the policy better.
I trust that you will find the above to be sufficient and in order.
Thanks and kind regards,
Paul Makwea
Ambledown Financial Services (Pty) Limited
Dear Ms Esterhuizen,
Thank you for your note and compliments on the claims process.
Your policy has been active for just over a year and you had 3 paid claims to date.
It is of concern when you question policy benefits at (3rd) claims stage and part of your claim is not covered.
Please engage with your broker to understand the function of the policy better.
I trust that you will find the above to be sufficient and in order.
Thanks and kind regards,
Paul Makwea
Ambledown Financial Services (Pty) Limited
