Poor Service. Hospitalization Claim unpaid.

I was hospitalized 5 Jan 2025 and had to immediately go to theatre for operation the very next day cos I had burst a colon which had to be removed... So on 06 Jan the doctor took out a sample for lab testing, it so happened that when Lancet was doing tests, they picked up something that signaled signs of cancer cells.... They went ahead and ran further tests to be sure, although these were not ordered by the doctor but they had reasonable grounds.

So now BONITAS refuses to pay for these because "they were not ordered". I went back to the doctor and he said "Infact they helped us because we'd have had to put in another request again to test for these. This happens all the time, I'll write you a motivation letter to give to your medical aid and it wont be an issue".

I took the motivation to Lancet so they can reprocess the claim now with the motivation....they sent me to Bonitas. Bonitas asked me for all supporting documents including the lab results and in the end still said "it was not ordered"....We've established all that, thats why there's a Motivation Letter from the doctor explaining this. I have been trying to resolve this since Feb while I was severely battling an illness, I spent hours on the phone and being driven to Bonitas Help Centers in Musgrave Durban....everyone from Bonitas keeps saying "dont worry it will be sorted, it happens all the time...ask Lancet to reprocess the claim and we'll pay it" Just yesterday I had a conference call with someone from Bonitas & Lancet, they both agreed this is nothing new but do not understand why Case Reviewer is not paying on this. Apparently Case Reviewers can not take calls and their word is final.

I've been a member since 2009, this is my 1st hospitalization and this is the treatment I get....while battling pains from a cut across my stomach and colon removal. Now I am fed up and ready to move my business to Discovery.