Bonita operates like the worst ****a shop! Bonitas should pay its members interest on delayed claims

May 21, 2025, 12:00 PM to claims, chronicmeds, queryclaims, queries

Dear Bonitas Customer Service Manager, Bonitas should pay its members interest on delayed claims, since Bonita's earns interest by withholding repayments for almost 3 months. I am writing to formally express my deep dissatisfaction with the continued poor service and inefficiency displayed by Bonitas Medical Aid. This pertains to a two-month delayed payment for a valid claim, as well as the repeated failure to authorise chronic medication for ... treatment, despite my medical doctor’s motivation and compliance with your requirements.

1. Unpaid Claim Despite Confirmation

It is unacceptable that a claim submitted over two months ago remains unpaid, even after formal confirmation on 17 April 2025 that the payment would be processed. Multiple follow-ups have been made, yet I have received only vague responses, broken promises, or no feedback at all. As of today, no payment has been received. This delay is unprofessional, entirely unjustifiable, and reflects systemic inefficiency in your claims administration. The lack of follow-through has caused both financial inconvenience and a serious erosion of trust in your service.

2. Failure to Approve Chronic Medication (*** | Auth ***)

Additionally, my treating doctor has motivated on multiple occasions for the approval of ....medication, which should fall under the prescribed minimum benefits (PMBs). Each time, Bonitas either delays the response by 1 to 2 weeks or provides an excuse to reject the application, despite complete and valid documentation.

Some of the consultants that I spoke to, and the other did not sign off their names on the email, but in total I have interacted with more than 7 to 10 people, and none of them have resolved my challenges.

1. Buhle Nqeno 7 May

2. Monique Thring 30 April

3. Jennifer Fourie, 20 May (This one was worse; she rejected the claim without seeking context and more information)

4. Dikeledi, 20 May, she promised to contact Jennifer yesterday, and call me back yesterday. I have not received a call

As a result, I have been forced to pay out-of-pocket for this necessary medication, which defeats the purpose of having comprehensive medical cover. The repeated delays and rejection of chronic cover not only compromise my health but also demonstrate an apparent reluctance by Bonitas to honour its commitments to members.

3. Expectations and Next Steps

I am requesting the following, without further delay:

Immediate payment of the outstanding claim with proof of payment. Immediate resolution and approval of the chronic medication application as per your obligations. A written explanation for both the claim delay and the denial of chronic medication, including reasons for previous delays and errors. Confirmation that this matter has been escalated internally and that appropriate corrective action is being taken. Should this not be resolved within three (2) business days of receipt, I will escalate the matter to the Council for Medical Schemes (CMS) and explore all formal channels available for recourse.

Your repeated failures in service delivery and communication are unacceptable and undermine the very purpose of medical coverage. I expect a prompt and professional resolution to both issues.

Sincerely,

THE CLAIM IS STILL NOT PAID!