Unfair practise and pathetic customer service from Bankmed

I would like to log a complaint against my medical scheme Bankmed for unfair practise and poor customer service, and would like to request your urgent assistance in having the matter resolved as soon as possible. I have also sent emails to the complaints department and one of the executives I am not even receiving acknowledgement of receipt on my email.

I am a 35 year old female with progressive hearing impairment. I was fortunate enough to receive my first cochlear implant on 14 July 2014, this has improved the quality of my life tremendously and I have been able to overcome so many challenges faced with my hearing impairment. Upon my latest check-up my Dr recommended that I consider a second cochlear to enable me to have balanced hearing, this would be the best thing for me as am still faced with hearing difficulty when people speak to me from my right side, this has an impact on my career and social interactions, hence I agreed to the second implant. The Drs submitted the application to bankmed for a second implant, and to my pleasant surprise, on 20 August 2019, I received an approval from bankmed for the procedure and the cochlear device, we then proceeded to plan my procedure which was scheduled to take place tomorrow 04 September 2019. Please find the below list of events which followed.

1. 20 August 2019, bankmed approved the procedure and funding of a second cochlear device, the Dr and JCIC continued to plan the procedure set for 04 September 2019 2. 21 August my Dr informed me that bankmed had retracted the approval, as per the bankmed policy they will only fund one cochlear, once in a lifetime. 3. 22 August the Dr sent through a motivation letter to bankmed to reconsider the outcome and stated the benefits of the second implant, in addition to this advised that bankmed had made previous exceptions and funded a second cochlear for other patients. In addition to this I sent a formal complaint by following the bankmed complaints process. 4. 27 August The Dr notified me that bankmed had reviewed the request and once again approved the procedure and the cochlear device, we proceeded to plan for the procedure set to take place tomorrow 04 September 2019. 5. Today 03 September 2019, my Dr notified me that Bankmed has once again retracted the approval for the reason that I have a cochlear already and this is a once in a lifetime funding as per the bankmed policy.

In View of the above, I feel that bankmed has treated me extremely unfairly and caused me a lot of emotional distress by providing me with false hope that I would have improved hearing , in addition to this, Bankmed has caused me a lot of inconvenience and embarrassment as I have made all the necessary arrangements with my employer and on a personal scale to make provision for my time off in recovery and in turn have inconvenienced a lot of other people who had to reschedule their plans to assist me during my recovery. The medical team planned the procedure and did the ordering of the device, these errors from bankmed has also an inconvenience to them as they booked the surgery, this could have been used for another procedures or appointments. I do not find the decline reason to be fair, nor do I find the process of approval to be fair or transparent as previously mentioned bankmed has infact funded second implants for other bankmed members and the fact that I was approved twice and later decline is completely unfair and unacceptable. I request that bankmed urgently review my grievance and provide me with feedback as soon as possible, as I will continue to escalate until a fair outcome is reached.