1 reviews | Active since Jan 2025
How we got ****med by Medway Gap Cover and Ambledown Financial Services
Utterly gutted and disgusted with Medway Gap cover by Ambledown. Especially with being a client with them for well over 3 years and not missing any premium.
My wife had a Ceaserian in December last year (2024), naturally, there were amounts that were not covered by medical aid, due to the increased costs in our Healthcare system. After the stress of navigating the bills and ensuring a comfortable space for our new born, we finally put a claim through to Medway gap only to be met with countless issues and discrepancies. At first, we were rejected based on not sending the correct documentation. The documents in question were forwarded 3 times and apparently the person who was reviewing this could not see the missing information they requested (rejection code which was clearly outlined in our medical aid statements).
When we got no joy on Email I finally decided to call them, only to be met with the same incompetency. No one knows what's going on, no one knows how to assist us with our policy. We kept being being told we will be contacted and we're asked to send through the same documents over and over again, first by Julie with a follow up (that never happened), then we dealt with Princess (who assured me that I have sent through the relevant documentation and she will follow up with me personally. Only to be sent an email, a week later, stating that "apparently our policy does not cover hospital bills". After an entire MONTH! What do we pay Gap Cover for, if not to cover our shortfalls from our medical bills?
We feel used, ****med, and ****** from. If this is not a **** to just get us to pay every month without actually doing what they are meant to in a time of a claim, then I do not know what is.
Thank you for your review above.
"Copy of the letter sent to your email."
Our Sincere Apologies for Your Recent Experience
We sincerely regret the frustration and inconvenience you experienced during your recent claims interaction with us. Providing excellent service is our top priority, and we acknowledge that in this instance, we fell short of that commitment.
We understand how frustrating it must have been to be asked for documents that had already been submitted. This should not have happened, and we deeply apologise for the unnecessary delay and any confusion it may have caused.
Your Gap Insurance Policy is designed to cover shortfalls related to in-hospital specialist and doctor treatment when admitted for a day or more. It does not extend to cover shortfalls for hospital stays but rather ensures that you are covered for the difference between the specialist’s costs and what your medical aid pays. We regret any misunderstanding regarding this coverage and appreciate the opportunity to clarify.
Your feedback is invaluable to us, and we are taking immediate steps to prevent similar issues from occurring in the future. Please know that we truly value you as our client, and we appreciate your patience and understanding.
If there is anything further that we can do to assist you, please do not hesitate to reach out.
Kind regards,
MP Makwea
***
Thank you for your review above.
"Copy of the letter sent to your email."
Our Sincere Apologies for Your Recent Experience
We sincerely regret the frustration and inconvenience you experienced during your recent claims interaction with us. Providing excellent service is our top priority, and we acknowledge that in this instance, we fell short of that commitment.
We understand how frustrating it must have been to be asked for documents that had already been submitted. This should not have happened, and we deeply apologise for the unnecessary delay and any confusion it may have caused.
Your Gap Insurance Policy is designed to cover shortfalls related to in-hospital specialist and doctor treatment when admitted for a day or more. It does not extend to cover shortfalls for hospital stays but rather ensures that you are covered for the difference between the specialist’s costs and what your medical aid pays. We regret any misunderstanding regarding this coverage and appreciate the opportunity to clarify.
Your feedback is invaluable to us, and we are taking immediate steps to prevent similar issues from occurring in the future. Please know that we truly value you as our client, and we appreciate your patience and understanding.
If there is anything further that we can do to assist you, please do not hesitate to reach out.
Kind regards,
MP Makwea
***