BJ
Brenda J

1 reviews | Active since Sept 2017

26 Sept 2017, 11:34

No flexibility under exceptional circumstances

I am the main member of Bonitas Medical Scheme. Membership number ********** 1181. Authorising ref number BON ********** 6. My husband urgently needs a corrective op on his ankle due to falling off a ladder at work. However he works in Nigeria and there is no workman's compensation for expats In Nigeria. When we consulted the specialist who has to perform the surgery, we were honest about how the accident happened and he duly allocated the procedure as Injury on Duty with the appropriate codes. Bonitas has subsequently declined to pay for ANYTHING due to the codes stating it as an IOD. After explaining numerous times that this happened out of the country they will not budge as the codes indicate IOD and the rules don't allow any exception. They advised that the specialist should change the codes but of course he cant do that without his integrity being questioned! After many phone calls and letters of motivation, I was again informed today that they can't do anything about it because of the codes and we are therefore completely responsible for all costs involved which is overwhelming.

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Replies (2)
Bonitas Medical Fund
Bonitas Medical Fund's reply26 Sept 2017, 17:38
Official

Hello ***,

Thank you for submitting a comment to us through Hello Peter.

This is to confirm that we have received your comment and that we are currently investigating this matter.

Our representative will be in touch with you shortly to discuss this matter and ensure that it is speedily resolved.

Kind regards,

Bonitas Team

BJ
Brenda J's update03 Jan 2018, 09:22
Reviewer Update
I received an authorization number on the day my husband was being operated on AFTER I had to pay the hospital over R 70 000 cash before the hospital would admit him for the op. I am still waiting to be refunded any money as the hospital refuses to deal with medical aids. Bonitas has received the claim from the hospital as I personally forwarded it to them. This issue has STILL not been resolved despite numerous emails, phone calls etc. Its now been 3 months