Unhappy with Bonitas

Good day This letter/email is in line with the set down requirements by the Ombudsman. Bonitas is therefore given 14 working days to respond to this request. Previously I had a medical aid with Bonitas (BonCap) ********** 3337; due to change of employment, I had to cancel the medical aid. I had to reapply for my brother Believe Mkhonto ( ********** 701086). Bonitas gave me a new medical aid number ********** 7925. He was hospitalized on first of March 2018 and Bonitas are of the view that they won’t pay but here are my arguments why they should pay.

1. When I cancelled my old medical aid ( ********** 3337) I believe that when I requested information about making my brother the main member on the old medical aid they should have advanced me about the benefits that I would lose since they advanced me about reapplying for a new one. It shows the lack of professionalism as they only saw new business. 2. They appointed a broker for me. The broker’s job was not fulfilled because the broker failed to help me fill in the form as that is part of their job. She just sent me a form and said fill it in and say no when they ask about any historical background. Bonitas are taking me pillar to post as they are of the view that I need to speak to the broker however, they assigned the broker to me. Again clearly, it shows the lack of professionalism, as I did not appoint the broker myself. I cannot explain the detailed job of a broker however, they need to help you fill in the form and ask questions not just look at making quick money. The broker’s name is Mpumi Skosana of Tenda Health. Contact details ********** email address ********** 3. When Bonitas accepted the application, they should have sent me a medical aid certificate and from my records and theirs, they did not send me. The medical aid certificate clearly underpins general rules and without how should I know the rules? Bonitas yet again is on the wrong side. 4. On my application, I undertook to be pre underwritten by the company. My understanding of underwriting is the following: is a health insurance term referring to the use of medical or health information in the evaluation of an applicant for coverage, typically for life or health insurance. With that being said they had all the information about my brother's health record they could’ve told me that they will impose a waiting period before I can use the medical aid. I may not have indicated on the form because of the brokers advance but their job as underwriters is to check if there was any history of the old medical aid. 5. On 1 March 2018, I called in the call centre to check if my brother can be hospitalized and the agent said yes and from that, I followed the information given. The next the agent said that the benefit has been revoked. That for me shows that the agent is not professional and should be liable as well. 010318qmzmtw this is the reference number of the call. 6. On Friday 2 March 2018, I called in again to check the status of the request and I was told that it has been declined and they contacted the Dr Sikhosana. I, later on, called the Dr and he said they did not contact him at all. I have cc’d him on the email so that he speaks for himself. If they got the information from previous records clearly, they should have told me about the waiting period.

I am unhappy with the service I received from Bonitas. They do not take their clients seriously. They are unprofessional and they have created problems for me. Upon application, they say nothing and they wait for you to use the medical aid and they start quoting general rules for you. This should be done from application stage. At this point, I still maintain that they should pay.

Regards Mpilo