JV
Jolanda V

1 reviews | Active since Sept 2024

09 Sept 2024, 16:24

DISGUSTED!!!!!

If I could give no starts here I would. Bestmed decided to cancel my membership on Friday, after a pre-auth request from my OBGYN for a hysteroscopy to get my IUD removed, as it has moved out of place and migrated into my uterus where it has been wreaking havoc the past few months.

Their reason for my cancellation was that I had not disclosed I had an IUD, but their disclosure form had no section where this was asked to be disclosed.

I have been emailing, calling, chatting etc just to be told I can't talk to an actual PERSON in the escalations department and they have a turnaround time of 3 - 5 business days and to again rather their corporate governance team, no PERSON from this department could give me call or email me.

So quick to take your money and premiums - yes, they have my September membership fee, but yet a few days later, they cancelled my membership...

Nevertheless - Bestmed, know this, for the extra days of pain I am now enduring, you will be taken to Ombudsman, CMS and if I have to - small claims court for the funds of the membership and the cost of the procedure.

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Replies (4)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply10 Sept 2024, 09:19
Official
Dear Jolanda,

We understand your concern and would like to clarify the reason for this action. Your membership was terminated retroactively due to the non-disclosure of material information, specifically the existence of an intrauterine device (IUD). This information is considered crucial for assessing your risk profile and determining appropriate coverage.

If you believe that you have provided all necessary information at the time of membership application, we invite you to submit any supporting evidence to our appeals department. Please note that until such evidence is presented, the termination of your membership will remain in effect.

As outlined in our previous communication, we will be refunding all premiums paid by you, minus any claims paid by us, to your designated bank account shortly.

If you remain dissatisfied with this outcome, you have the right to approach the Council for Medical Schemes (CMS) for adjudication.

We appreciate your understanding and cooperation in this matter. 

With Kind Regards
KS
JV
Jolanda V's update10 Sept 2024, 09:28
Reviewer Update
I need a phone call from someone in your department!!! Because I did provide you with a copy of your very own disclosure form where IUD or contraception information is NOT ASKED! If it was on the form I would have disclosed it, like I disclosed everything else that I was aware of!!!!
JV
Jolanda V's update10 Sept 2024, 09:29
Reviewer Update
So please, can someone just call me!!!
Bestmed Medical Scheme
Bestmed Medical Scheme's reply11 Sept 2024, 09:26
Official
Dear Jolanda,

Following our telephone discussion, we have conducted an internal review of the matter. Unfortunately, our decision remains unchanged. 

Best regards
KB