JM
Juliet M

1 reviews | Active since Mar 2021

04 Mar 2021, 09:42

Bonitas direct violation of GCP standards

Bonitas has indicated that my elderly mother is not allowed to receive a claim on the covid test we had performed in an emergency situation. Even though nationally it was communicated that medical aids will cover covid 19 tests. This company is now using every excuse in the book to reject our claim. I have also spoken to 2 team leaders i.e. Lynn and Fizana who have tried to blame shift from myself and my elderly mother to Dischem to the lab to everyone else as to why they will not accept our claim. This goes against the code of good practice and needs us to log a complaint with the ombudsman.

0
Replies (3)
Bonitas Medical Fund
Bonitas Medical Fund's reply04 Mar 2021, 10:44
Official
Hello Juliet M,

Thank you for notifying us of your complaint, 
 
 We are currently investigating this matter. 
 
 We appreciate your patience while we are resolving this query for you.
 
Regards,
 
 Bonitas Team
JM
Juliet M's update05 Mar 2021, 07:51
Reviewer Update
I fully plan to do so as this matter remains un resolved. I will escalate further until Bonitas provides me the claim that is valid. The reasons mentioned in your current replies differ from what Fizana and Lynn quoted and as such there is no belief in your internal processes.

Instead of asking your client to log this complaint YOUR business can do the utmost to resolve the matter and have my money returned to me. YOU can log a complaint to get this claim processed in stead of giving me new reasons why you refuse to do so.

Recourse to your employees. What a joke. Bonitas has no morals and no plans to address my case. I know this.

I have had to do much of the work on my queries as proxy for my mother’s account. Per the current ruling that Bonitas is clinging to, they are expecting a 75 year old elderly woman that has displayed symptoms of COVID19 to be forced to first go to a doctor right during the peak Christmas season (attachment 2 proof of test/claim) and get a referral before they would have processed this claim. As a high-risk individual during the well-publicised second wave of this debilitating disease that has overcome our nation, this could have led to my mother’s demise due to secondary infections (to mention only one). Indirectly, Bonitas are saying that my elderly mother should have risked potential death before they would lift a finger and rectify their processes in covering this claim. Do we allow businesses, no medical aid schemes, to continue to conduct themselves in this manner? I could not stand for this.

This case will not go away until Justice is served.

JM
Juliet M's update05 Mar 2021, 08:00
Reviewer Update
You write (as the default text I am sure with no regard for your customers)..." This is not the normal standards that we set in terms of customer service delivery, and internal measures will be taken to further address this. We are committed to reinforce the relationship between Medscheme and you as our valued member. "

This is an insult to my intelligence as just above you show clearly that this is in fact not the case. You care about blame shifting and not going above and beyond to cover your customers for the claims during a time of a GLOBAL pandemic. There will be no commitment to reinforce this relationship on Bonitas side I am sure. How will you do this? I have yet to receive a full acknowledgement that Bonitas is at fault. I have not received the promised letter from Fazana for the disgusting service I received? Your not even willing to cover the costs? Do expect to reinforce this relationship with a mere "sorry" this is doin the very least and shows 0% of you so called "commitment"

How does one have any faith that you will cover the vaccine? FYI as I am sure your not aware both covid19 tests and vaccines should be covered by ones medical scheme as well publicized.
As such Bonitas is currently non compliant.