EH
Etienne H

1 reviews | Active since Feb 2024

25 Feb 2024, 10:50

BESTMED MATERNITY BENEFITS VERSUS NON-DISCLOSED MEDICAL CONDITIONS

My daughter was on my Bestmed Scheme until 2018 when she was no longer a student and got her own Bestmed Med Aid. In 2014 whilst still on my Med Aid due to personal stress/stomach related issues she visited our GP who treated her for stress but unbeknown to us he seemed to have diagnosed her having Irritable Bowel Syndrome (IBS). For the past 10 years did she neither have any similar conditions again. As mentioned in 2018 she went onto her own Bestmed Med Aid and did not tick on the application form that she had any Digestive System related issues. Now in Jan 2024 - 10 years later - her son was born and Bestmed refuse to pay the medical bills on account of NON-DISCLOSURE. I am not a GP but how is IBS and your crucial Maternity benefits related? And if Bestmed retrieved her medical records from our GP why was my daughter not contacted and warned in 2018 when she joined Bestmed that there may be a future problems claiming for Maternity benefits? I find this totally unacceptable and irregular unless someone can explain the connection between IBS and Maternity benefits to me. So right now we are out of pocket by almost R80k having had to pay cash upfront. Bestmed members need to be made aware of these traps set by inconsiderate medical aids.

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Replies (3)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply27 Feb 2024, 11:05
Official
Dear Etienne

Kindly be advised that correspondence has been dispatched to the member concerning the termination of their membership due to non-disclosure. The member has been duly informed of the specific medical condition or diagnosis that precipitated the termination.

Regrettably, in adherence to POPIA regulations, I am unable to provide additional details to third parties.

Regards
Nondumiso
EH
Etienne H's update29 Feb 2024, 10:28
Reviewer Update
You have not answered my question and statement. Bestmed just cancelled her membership and offered "non-disclosure" as the reason. She still does not know exactly when the "non-disclosure" reason occurred and exactly what it was. Why did Bestmed not informed her immediately when they noticed some "non-disclosure" rule has been transgressed and that this will have an affect on her future claims for maternity benefits? Instead Bestmed kept on accepting her monthly fees. I expect Bestmed to at least have the decency to offer her a extensive explanation in wrirting. We are dealing with human beings after all.
Bestmed Medical Scheme
Bestmed Medical Scheme's reply29 Feb 2024, 11:25
Official
Dear Etienne

Please note that all the details regarding this matter were sent to the member. We are unable to disclose any information to a third party due to POPIA regulations.

Regards
Nondumiso