SR
Sharon R

1 reviews | Active since Jan 2019

02 Jan 2019, 14:30

BIDVEST LIFE ****S CLIENTS!

BIDVEST LIFE AUTOMOTIVE - 2 January 2019

Policy Holder - TG Van Rooyen Policy nr: B ********** 910

I Sharon van Rooyen, would hereby like to dispute a claim that was not paid out. The situation was mismanaged and as a result of this mismanagement, my late husband’s claim was declined.

Just to start with the history of the policy. Late Mr TG Van Rooyen bought a Polo Vivo Conseptline - 7 August 2018 from Bidvest McCarthy Witbank. The day when he took delivery from Bidvest the Fais Representative Mr Ettiene De Klerk offered a credit life insurance to him for death, disability and retrenchment if any of these disasters occur. Mr Van Rooyen informed him about his heart attack in 2011 (7 years prior) and was thus transparent and did not hide his condition. Mr Van Rooyen also informed Mr De Klerk he was under no chronic medical treatment. Mr De Klerk then informed my late husband that because the heart attack was 7 years back it would not have an effect on his policy/insurance. Mr De Klerk ran through the policy schedule briefly and asked Mr Van Rooyen to sign on an electronic tablet, which my late husband did as he trusted that this was normal procedure. My husband was under the impression that his pre-existing condition would not affect his credit life cover and its benefits.MR DE KLERK DID NOT DISCLOSE TO MY HUSBAND THAT HIS PRE-EXISTING CONDITION WOULD INDEED HAVE A NEGATIVE EFFECT ON HIS POLICY.NO MEDICAL QUESTIONS WERE REQUESTED. NOR WAS A HARD COPY OF THE POLICY GIVEN TO MR VAN ROOYEN IN ORDER FOR HIM TO READ THROUGH AND UNDERSTAND THE CONDITIONS FULLY.MR VAN ROOYEN WAS UNDER THE IMPRESSION THAT THIS WAS NORMAL PROCEDURE. Mr De Klerk was supposed to send the policy documents to us via email or normal mail. I requested a copy of the policy documents on 19 October 2018. I requested these documents as this was when the irregularities were brought to my attention. This was the first time that I had access to the policy details.

Mr Van Rooyen trusted that Bidvest Life was the right insurance company and that they would take care of his needs as they promised. Mr Van Rooyen was a loyal and honest costumer and unfortunately he was not treated as such.

Mr Van Rooyen’s condition sadly turned around and was admitted at Steve Biko Academic Hospital on 16 December 2017 and he was hospitalized until 29 December 2017. Dr vd Lan told Mr Van Rooyen to come back to Steve Biko on 18 January 2018 for further assessment, because of the skeleton staff and the machinery only being able to be operated from 15 January 2018. Mr Van Rooyen was admitted again on 18 January 2018 until he passed away on 2 February 2018.

I contacted MFC Finance (Finance company) and IUA (Bidvest Life) on 8 February 2018 to inform them all about the death of Mr Van Rooyen. All supporting documents and information was sent to IUA (Bidvest Life) and MFC to start with the death claim. IUA requested on October 2018 the hospital records and I had to pay for the hospital records and went to Pretoria to collect the records and I emailed the records on 1 November 2018 to IUA. IUA (Bidvest Life) did not provide me with necessary feedback as I asked them on numerous occasions. I was left in the dark and I did not know how to proceed. The claim has been submitted almost 11 months ago.

On 7 December 2018, I phoned IUA (Bidvest Life) and spoke to Bridgette (assessor) and she informed me all documents were received and they referred the claim to the insurer, Bidvest Life for further assessment of the claim. I sent an e-mail to IUA on 18 October 2018 because I was dissatisfied with how this claim was treated. Bridgette assured me that she would phone me back the next Monday or Tuesday with feedback from Bidvest which she did not. I phoned again and she informed me that the insurer (Bidvest Life) sent the attached letter that said the claim was declined due to the following reasons :

------------------------------------------------------------------------------------------------------------------------------------------------- According to the medical records received, insured was presented at Steve Biko Academic hospital on the 16th January 2017 with decompensated heart failure, ischaemic cardiomyopathy and on various medications. Therefore, it is confirmed that the insured passed away from a condition that pre-existed the commencement of cover, which then is specifically excluded.

I am dumbfounded that the claim was rejected / declined on the conditions as stated above. The date is INCORRECT as Mr van Rooyen was hospitalized from 16 December 2017 - 2 February 2018. Dr Brits approved a weekend pass on 26 January 2018, because Mr Van Rooyen’s condition was not critical. He went back on the Sunday 28 January 2018 for further treatment until he passed away on 2 February 2018. ---------------------------------------------------------------------------------------------------------------- b) Pre-existing conditions exclusion I/We, the Live(s) Assured, understand, agree and declare that: No claim will be payable during the 24 (twenty four) month period after the commencement of Insurance or date of reinstatement where the Insured Person suffered from any condition (i.e. any medical condition, physical defect, illness, bodily Injury or disability) of which the Insured Person was aware of or ought reasonably to have been aware of and for which the Insured Person received treatment or consulted a medical professional in the 24 (Twenty four) month period prior to the commencement of insurance or date of reinstatement and where the claim event was caused directly or indirectly by such pre-existing condition. Pre-existing conditions include any: • heart disease or heart attack, high blood pressure or high cholesterol; • cancer • stroke • kidney disease • pneumonia, asthma, tuberculosis or lung ailment; • diabetes; • depression, epilepsy, or fit; • disability (including back-ailment, hip, knee or shoulder problem); • disease or condition which requires chronic medication usage; • any disease or condition which required medical treatment because a special investigation, such as a scan or an X-ray, showed abnormal results.

I am dumbfounded that the claim was rejected / declined on the conditions as stated above. MR VAN ROOYEN WAS NOT AWARE OF THESE EXCLUSIONS OF THE POLICY. I witnessed that day and remembered the conversation between Mr Van Rooyen and Fias Representative Mr Ettiene De Klerk as if it was yesterday. I am willing to sign an affidavit that corresponds with the information I witnessed on 7 August 2017. Mr de Klerk neglected to inform us of the terms and conditions of the policy.

I am still mourning the loss of my husband and all the stress of the claim affects my personal and working life. I am the sole provider for my child that is still a student and cannot afford not to have transport that is why my husband took the policy out to provide for us if he passed away. When one sees a reputable brand such as Bidvest, you would expect an honest and ethical service. They failed to provide us with the crucial information that could result in us not being able to claim from the policy. It is as if Bidvest won’t hesitate to take YOUR monthly premiums, even if they know that they will not support your claim. All of this whilst mourning the loss of your family’s financial provider, leaving a women and child without the support their client entrusted unto them. What I wish to achieve with this letter, is that Bidvest will take responsibility for their poor service and pay out the claim. They need to take responsibility and correct the negligence their representative caused. I also wish to ask that in future that they conduct their business fairly and hold their end of the bargain. Herewith attached documents: 1. Daily Hospital reports 2. Weekend pass 3. Discharge Report I look forward to hearing from you

Warm Regards, Sharon Van Rooyen ********** 377

0
Replies (8)
Bidvest Insurance
Bidvest Insurance's reply02 Jan 2019, 15:19
Official
Dear Mrs Van Rooyen 

We acknowledge receipt of your complaint and note the content thereof. 
Kindly note that your matter has been assigned to a Complaints Administrator and is currently being investigated. We will provide you with a response shortly upon completion. 

We appreciate your patience in this regard.

Kind regards
IUA Business Solutions - Complaints Team
Bidvest Insurance
Bidvest Insurance's reply03 Jan 2019, 16:13
Official
Dear Mrs Van Rooyen, 

Please note that a response has been sent to you on email.

Kind Regards,
IUA COMPLAINTS TEAM
SR
Sharon R's update03 Jan 2019, 17:31
Reviewer Update
"The policy inception date was 7 August 2017 and the date of death was 2 February 2018. Therefore the death occurred within 6 months of cover commencing. The insured was hospitalised in January and February 2018 for the acute coronary syndrome and passed away due to cardiac failure. Medical records confirm a consultation on 16 January 2017 at the Department of Nuclear Medicine – HF Verwoerd Hospital, the insured was diagnosed with Ischaemic Cardiomyopathy and was treated with various medications. Therefore, it is confirmed the insured passed away from a condition that he received treatment for in the 24 months prior to the commencement of cover, which then is specially excluded. We confirm that the claim will remain declined as the pre-existing clause is applicable. We regret any inconvenience that you may have experienced and trust that the above clarifies. Kind Regards Rashika Dayanund Complaints Resolution Administrator" The above mentioned is the response I received from IUA Business Solutions. Why do you lie in writing ?? !! My husband was not admitted or treated with any medical condition on 16 January 2017 at any hospital neither was he consulting a medical practitioner!!!! As he was the breadwinner of our family he was at work on 16 January 2017!!!!! IT HAS BEEN 11 MONTHS SINCE HE PASSED AND I SUBMITTED PAPERWORK AFTER PAPERWORK AND STILL BIDVEST/ IUA LIES IN WRITING!!!!!!!!!!! ALL STALL TACTICS!!!!!! JUST TAKE A LOOK AT ALL THESE NEGATIVE RESULTS ON BOTH IUA AND BIDVEST ON HELLO PETER ALONE, SHAME ON YOU FOR FALSE REPRESENTATION TO YOUR CLIENTS AND FOR MAKING THEM BELIEVE THEY ARE COVERED WHEN IN ACTUAL FACT YOU JUST CON PEOPLE WITH YOUR POLICIES. Why have you not provided me with the proper documents to support your false claims that my late husband was aware of these extra clauses, As previously stated my husband DID NOT SIGN A HARD COPY POLICY SCHEDULE NOR DID HE RECEIVE ONE. He only signed on an electronic pad that did not include the policy schedule. As stated numerous times I only RECEIVED THE POLICY SCHEDULE ON 18 OCTOBER 2018 !!!!!! You stated that the policy would not pay out during the first 6 months, but this was a CREDIT INSURANCE POLICY / PROTECTION SETTLEMENT POLICY. If Mr Van Rooyen did not conform to the policy rules why did they not send him for medical examinations and why did Mr De Klerk not disclose ANY OF THIS INFORMATION TO THE INSURER BEFORE HAND. If Bidvest/IUA knew Mr Van Rooyen was previously diagnosed (WHICH HE WAS NOT) WHY CLEAR HIM IN THE FIRST PLACE AND ALLOW PREMIUMS TO BE PAID!!!!!!!???????? He had a heart attack in 2011, but he disclosed it to Mr De Klerk who said IT WOULD NOT EFFECT HIS POLICY IN ANYWAY!!!!!!!! SHAME ON YOU!!!!!!!!!!!!! PLEASE READ THE MEDICAL RECORDS OF MR VAN ROOYEN PROPERLY AS HE WAS NOT ADMITTED AT HF VERWOERD HOSPITAL, BUT AT STEVE BIKO ON 16 DECEMBER 2017 AND NOT 16 JANUARY 2017!!!!!! Not only do you lie in writing but you cant do the math either. So with your calculations you claim that Mr Van Rooyen was hospitalised FOR 1 YEAR AND 17 DAYS UNTIL HE PASSED. Getting back to 16 January 2017 which you stated he was admitted in hospital how was this possible????? Did he buy this insurance policy from his hospital bed. Let me do your calculations for you correctly: - Mr Van Rooyen was first admitted on 16 December 2017 until 29 December 2017 (Steve Biko discharge form was also given to IUA/Bidvest) - Mr Van Rooyen started working on 3 January 2018 until 12 January 2018. - He was re-admitted at Steve Biko on doctor's request on 18 January 2018 until he passed away on 2 February 2018. - His medical condition was well enough that doctor Brits discharged him on a weekend pass from 26 January 2018 until 28 January 2018. My current situation is that MFC Finance wants to repossess my vehicle which is insured with IUA/Bidvest under a credit life policy !!!!!!!!!! IS THIS THE WAY YOU TREAT A TRUSTED CLIENT, YOU DON'T EVEN HAVE THE DECENCY TO TAKE THE TIME FOR A PHONE CALL INSTEAD I GET A COLD IN PERSONAL EMAIL!!!!!!! This is after I went out of my way driving to Steve Biko Hospital to collect the medical reports for IUA/Bidvest!!!!!!! PATHETIC!!!!!!!!!
Bidvest Insurance
Bidvest Insurance's reply03 Jan 2019, 17:58
Official
Dear Mrs Van Rooyen,

We acknowledge receipt of your additional comments and a response will be provided via email.

Kind Regards,
IUA COMPLAINTS TEAM
SR
Sharon R's update04 Jan 2019, 06:35
Reviewer Update
Morning Rashika, To ad on my previous email. If you open the hospital record (previous attachment) you will see on top of the page in the corner a hospital sticker with all the details of late Mr Van Rooyen with his hospital number and the admission date will be appear on the form. Also to review your statement of the 6 months period of commencing of claim, Mr Van Rooyen took out the credit life/ settlement protection policy out on 7 August 2017 and premiums was deducted from his bank account as from end of August 2017 until end of January 2018. Remember he passed away 2 February 2018 so all premiums was stopped after his death. If I calculate correct it will be 6 months.....???? I have read through the policy documents after I have received them on 18 October 2018 (for the first time) and did not see a clause about 6 months period........ Rashika, the policy is a Auto Settlement plan as you stated in your email before this is a policy for credit settlement if anything drastic happens to a client....am I correct!!!!!! Then the credit still own by a client will be covered with the financial institute.... As stated below about the 24 months period after commencing date. Mr Van Rooyen heart attach was 7 years back and his condition perfect with no medical treatment afterwords. Even if he sign on the policy documents the representative Mr De Klerk did not inform him that his heart attack of years back will be effect his policy if a claim will occur in the future. Also below I see that if a client consult a doctor prior in 24 months it will be exclusive. Mr Van Rooyen did not consult a doctor or had any medical treatment for the last 7 years. image.png PLEASE READ THE HOSPITAL RECORDS THROUGH. Print the records maybe you will see the correct dates appear on them. I trust the investigation will be finalised soon as I had said before I am still moaning of the death of my husband and this policy that was not explain to us correctly have an emotional stress on my lifestyle, because I am the breadwinner of my child now. Sharon Van Rooyen
Bidvest Insurance
Bidvest Insurance's reply04 Jan 2019, 08:27
Official
Dear Mrs Van Rooyen

We acknowledge receipt of your comments which will be reviewed. A response will be provided to your personal email.

Kind regards
Complaints Team
SR
Sharon R's update07 Jan 2019, 19:55
Reviewer Update
BIDVEST/IUA REP**** BACK TO ME SHARON VAN ROOYEN ON 7 JANUARY 2019 ---------------- BIDVEST EMAIL ON 7 JANUARY 2019------------------------- Dear Mrs van Rooyen, We acknowledge receipt of both your communications addressed to us via the Hello Peter Website as well as directly through to us, dated the 3 and 4 January 2019. We have taken note of the detailed comments made by yourself. On the email dated 3 January 2019, you have stated the IUA has **** to you. We respond that there were no lies in the response that was provided to you. The response was based on the attached medical records that you have provided for the claim assessment. We refer to the 1st page of the hospital records provided by yourself and attached for reference, an extract is found below: From the above extract, we note that Sarkin, who is the Head of the Department, has requested an MIBI and a Viability test. The request is signed by Sarkin and dated 14 January 2017, as highlighted in the above report for your ease of reference. As the above report is from a medical institution, it can be deduced that the insured was seen by a medical practitioner on the 14 January 2017. Further, Sarkin confirms the list of the daily medication which the insured is to be taking on a daily basis, as highlighted above. You have stated that Mr van Rooyen was at work on the 16 January 2017 and that you are able to provide the proof that the insured was at work on the 16 January 2017. You are free and welcome to provide any proof that can be used to review the claim. We confirm that we have stated that the report is dated 14 January 2017. We agree that it has been about 11 months since the claim was submitted. We further confirm receipt of various claim supporting evidence that has been provided by yourself, thank you for taking the time to provide same. We have noted your comments regarding the Hello Peter website and cannot comment on another complaint raised by another complainant. As provided in our previous response, I have again attached the signed Transaction Schedule for your ease of reference. The signed document where the insured has signed a declaration which confirms that the insured has received a copy of the policy document for each product that he has purchased, is sufficient proof that the insured received a copy of the policy document at the time the vehicle was purchased. We are unable to comment on when you, as the spouse, had sight of the policy document. We comment that we have not responded as per your comments: “You stated that the policy would not pay out during the first 6 months”. The Credit Protection Plan Policy is not medically underwritten. This means that there is no medical questionnaire to be completed by the insured. Anyone that qualifies for the vehicle finance is offered the policy. The insurer relies on various exclusion clauses in the policy wording to assist the insurer to avoid certain losses. You have commented that Mr de Klerk was aware that the insured had previously experienced a heart attack in 2011. This is certainly not in dispute. While the insured may have had a previous heart attack, the insured would have still been offered the policy. The insured would have benefited from the policy if the insured had passed on from a heart attack after the 24 month period after the commencement of the policy. We have not claimed that the insured was hospitalised for 1 year and 17 days as you have alluded. While we have empathy for the situation that you find yourself in, the insured did not qualify for a claim although there was a credit protection plan in place. We confirm that the policy has no liability for a claim due to a pre-existing condition. The insured passed away from a condition that he received treatment for in the 24 months prior to the commencement of cover, which then is specifically excluded. We confirm that the claim will remain declined as the pre-existing clause is applicable. You are welcome to provide any new information that you may be have in your possession to support your comments. The insurer will be glad to review the claim accordingly. We trust that you would find the above in order. Kind regards, Rashika Dayanund Complaints Resolution Administrator SHARON VAN ROOYEN RESPONSE ON BIDVEST/LIFE EMAIL DATED 7 JANUARY 2019------ Good Afternoon Rashika, On Friday 4 January 2019 you phoned me 3h13 pm and we have discussed the following: (Our telephonic discussion is also on my voice recorder) 1. The date on the form of the Department of Nuclear Medicine as well as you had a query about the hospital name that appear as HF Verwoerd Hospital. My response to you was that HF Verwoerd Hospital changed to Steve Biko Academic Hospital and I saw that HF Verwoerd still appear on the form, but it is the same hospital. You are welcome to phone the hospital and confirm if this is correct. I explained to you that the date that Dr Sarkin signed was first the year/month/date. 17 January 2018. I also informed you that if you review the forms you will see on the left hand of the paper an hospital sticker with all Mr Van Rooyen's details with the admission date that is 18 January 2018. I also told you that Mr Van Rooyen was at work on the "14 / 16 January 2017" as per your records and I will ask his employer Laerskool Taalfees for a letter or time sheet to prove his attendance on those days. I also explain to you once again as my previous emails that Mr Van Rooyen did not receive a hard copy from Mr De Klerk of the policy schedule and I only receive the hard copy 18 October 2018. We also discussed his admission and I told you, because Steve Biko is a Government Hospital the doctor admit him for test so if they needed to do test he is in hospital to do so. As you can see on the attach document they do test on a regular basis. You also asked me NOT to post a complained on HELLO PETER and email you directly!!!!!!!!!! I have nothing to hide so I will post on Hello Peter so that my voice can be heard.. You also assure me that you will phone me on Monday 7 January 2019 to give me feedback on the claim.... I also notice that you only emailed me with none of the involved parties I emailed you every time (Bidvest CEO, FIAS Ombuds, Complaints Ombuds, Claims IUA and Associate Complaint) I also need to comment on certain statements on your email below that was dated 7 January 2019: As provided in our previous response, I have again attached the signed Transaction Schedule for your ease of reference. The signed document where the insured has signed a declaration which confirms that the insured has received a copy of the policy document for each product that he has purchased, is sufficient proof that the insured received a copy of the policy document at the time the vehicle was purchased. We are unable to comment on when you, as the spouse, had sight of the policy document. We comment that we have not responded as per your comments: “You stated that the policy would not pay out during the first 6 months”. I have read the policy documents through and there is a signature of Mr Van Rooyen on, but once again he sign on a ELECTRONIC DEVICE and if you go further down on the same page in fact all the pages there is a space reading "Initial (non-electronic" and there is NO INITIALS not on one page. SO WHAT DOES THIS MEANS........???? Mr Van Rooyen did not receive a hard copy, he signed on the ELECTRONIC DEVICE to acknowledge it, BUT MR DE KLERK NEVER PRINTED THE HARD COPY FOR HIM TO INITIAL A DECLARATION OF THE POLICY TERMS AND CONDITIONS. Mr Van Rooyen trusted the Bidvest/IUA Representative when he signed the electronic policy documents because he believed that it was normal procedure. My signature does not appear on the documents. WAS IT SUPPOSE TO BE!!!! I am fully in my rights to asks questions because I am the executor of Mr Van Rooyen's estate. Also on 3 January 2019 you rep**** on a email " herefore the death occurred within 6 months of cover commencing" that is why I informed you that Mr Van Rooyen passed away six months after commencing of policy and 6 premiums was deducted from his bank account and this was not disclosed in the policy documents and if it does please send me proof. The Credit Protection Plan Policy is not medically underwritten. This means that there is no medical questionnaire to be completed by the insured. Anyone that qualifies for the vehicle finance is offered the policy. The insurer relies on various exclusion clauses in the policy wording to assist the insurer to avoid certain losses. Rashika if I understand correct the credit policy act is not medically underwritten and no medical questions was asked. THEN WHY IS MR VAN ROOYENS PREVIOUS HEART ATTACK 7 YEARS BACK BECOME A PROBLEM WITH THE CLAIM. NO EXCLUSION CLAUSES WAS EXPLAINED OR DISCUSSED WITH MR VAN ROOYEN. You have commented that Mr de Klerk was aware that the insured had previously experienced a heart attack in 2011. This is certainly not in dispute. While the insured may have had a previous heart attack, the insured would have still been offered the policy. The insured would have benefited from the policy if the insured had passed on from a heart attack after the 24 month period after the commencement of the policy. In the policy documents pg 6 'Auto Settlement" the following came under my attention ' if a insurer knew of a pre-existing condition prior 24 months" Mr Van Rooyen heart attack was 7 years back and he was under NO MEDICAL TREATMENT. NO CONDITION WAS PRIOR IN THE 24 MONTHS BEFORE COMMENCING OF POLICY. If a client been offered a credit life policy you have the assurance that you will be covered if anything happens to you. That is why it is a credit life policy to cover your outstanding credit. We have not claimed that the insured was hospitalised for 1 year and 17 days as you have alluded. WELL ACCORDING TO YOUR CALCULATIONS IT IS 1 YEAR AND 17 DAYS. INCORRECT CALCULATIONS!!!!!!! While we have empathy for the situation that you find yourself in, the insured did not qualify for a claim although there was a credit protection plan in place. We confirm that the policy has no liability for a claim due to a pre-existing condition. The insured passed away from a condition that he received treatment for in the 24 months prior to the commencement of cover, which then is specifically excluded. We confirm that the claim will remain declined as the pre-existing clause is applicable. Rashika in your emails you contradicts yourself one moment you talk about 24 month after commencing and next moment 24 months prior of commencing!!!!!! AGAIN AND AGAIN AND AGAIN ------ Mr Van Rooyen did not received any medical treatment in the 24 months prior of commencement of policy........... Dr Sarkin prescribed medication that's on the nuclear medication form to Mr Van Rooyen in January 2018 as per attached letter..... he also was scheduled for a MIBI scan and a Viability test after his admission on 18 January 2018. Also attached is the consent letter from Mr Van Rooyen dated 18 January 2018 to agree to do the MIBI scan and Viability test. So I am astonished where do you guys get 14/16 January 2017!!!!!!!!!! You are welcome to provide any new information that you may be have in your possession to support your comments. The insurer will be glad to review the claim accordingly. I will provide a letter from the employer on my next email due to schools only start on Wednesday to do so...... I attached the letter that Bridgette from IUA claims department sent me and according to that date it was stated that Dr Sarkin signed 16 January 2017. Well, now somewhere on your side is a mixed up with dates!!!!!!!!!!!!!! I hope and trust the information that IUA/Bivest Life have will be assessed correctly....... Trust to hear from you soon. Regards Sharon van Rooyen ********** 815/ ********** 377
Bidvest Insurance
Bidvest Insurance's reply08 Jan 2019, 08:12
Official
Dear Mrs Van Rooyen,

We note your numerous posts relating to this matter.  Kindly provide the outstanding information urgently.

 Kind Regards,
IUA COMPLAINTS TEAM