Hospital Pre-Authorization

I app**** for a hospital pre-authoristation dated July,15. This was after seeing my neurologist who referred me to another neurologist in order to be admitted into hospital to conduct a long term EEG monitoring as well as ECG thereafter if required.

Having started a new job and scheduled leave for the authorization,I had stressed to the numerous call center agents as well as to my broker the urgency of having required this procedure.

Bonitas t&c's stated the following :

1. There would be no general waiting period applicable to me as there were no pre-existing conditions, which was verified by my broker before commencement of the medical aid ( Having joined July,01,2019). 2. As a new member , my doctors would need to be contacted. -GP -Neurologists 3.This step was merely to "investigate "that i had in fact provided correct information in that there No pre-existing conditions. 4. I was sent an email on the Monday, stating that my authorization was denied with NO reason, to which i called Bonitas & over and above dealing with a new job, deadlines based on this hospital pre-authorization and being very unwell ,i had to deal with an incredibly rude call center agent who insisted that this was denied and as per his system was "under investigation". This call center agent was clearly *********** and insensitive and insisted that i was informed that this application was sent as "denied, pending investigation", to which i stated that there was no such email receipt.

This file had been sent back and fourth with significant money & time spent on calls running after Bonitas on feedback everyday ! Imagine as a patient the following :

1. Bonitas notifies you on the day of requiring authorization that your benefits were suspended to which you then are told by your broker, it is due to that , which caused the delay in authorization- When in fact Bonitas hadn't received the banking details to conduct the debit order , which was sent twice to relevant parties.Finance from Bonitas did not see any need to follow up after noting such details were missing ,instead they just suspended my benefits. 2. 2 GP'S were contacted as well as 2 neurologists- Since when did so any doctors need to be contacted on order to investigate pre-existing conditions. Nonetheless all details were provided because i had nothing to omit accordingly. Bonitas then stated that they could not get a hold of the doctors for 2 whole days, to which i followed up myself, clearly proving Bonitas ***********. The doctors had written motivational letters and sent them through on those days. I then followed up again the following day, but the call center agents insisted these were not received. 3.I was rushed into trauma on July, 19th , reasons still appear unknown,hence going to specialists, being admitted, in order to find out what is going on. I was in complete agony to which i had to be put onto morphine. I then called back again the next day and was told that Bonitas had the file in underwriting . I then followed up the again and was told the same thing. This was when i contacted my broker infuriated and frustrated. She clearly did not understand the depth of the back and fourth calls, chasing my tail day in & day out, being unwell.

Now i find out on the 3rd week that Bonitas is looking into a non-disclosure when the broker and forms clearly asked what "conditions"or "surgeries" existed/were done prior to joining Bonitas-Which i disclosed. Since when is having blackouts a condition and on what grounds can this constitute non-disclosure? If this was the case why was these kinds of questions not asked ? i now am so unwell and may possibly be imposed on a waiting period (All due to the lack of competency of Bonitas .

Its evident that Bonitas is looking for reasons not to pay out for my authorization and that their patients do not mean anything to them.

My heart goes out to patients who are unwell and have to suffer the same issues.