KN
Kagiso N

1 reviews | Active since Feb 2017

11 Nov 2024, 11:46

Urgent Clarification Needed on Claim Rejection for Insufficient Documentation

Dear Customer Service Manager / Claims Department Team,

I am writing to express my frustration and seek immediate assistance regarding the repeated rejection of our claim for my daughter’s hospitalization. Despite providing all the required documentation, including:

A detailed Doctor’s Report explaining her admission, and A Motivation Letter outlining the sequence of events leading to hospitalization, our application continues to be denied due to “INSUFFICIENT DOCUMENTATION.”

We have reached out multiple times to seek clarification on what additional information may be needed, but no concrete guidance has been provided. This lack of support has been both disappointing and distressing for our family.

Given the circumstances, the hospital and the attending doctor are now involved to assist, as even they are uncertain about what further documentation is being requested. We feel that this ongoing rejection may be an attempt to avoid processing our claim, which has led us to lose confidence in your service.

Could you please provide a clear, itemized explanation of any missing information or additional requirements necessary for claim approval? Your prompt response would be greatly appreciated to help us avoid further delay.

Thank you for your attention to this urgent matter.

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Replies (1)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply12 Nov 2024, 11:41
Official
 
We sincerely apologize for the inconvenience caused. Your complaint has been escalated to the Hospital Benefit Management Department team leaders for urgent assistance. We will ensure that feedback is provided to you as soon as possible.
Thank you for your patience and understanding.
Kind regards,
TP