Unresolved Emergency PMB Claims Despite Repeated Follow-Ups

I am extremely disappointed with Bonitas regarding my mother’s unpaid/partially paid claims following emergency treatment.

I first raised this matter on 29 June 2026, followed up on 21 July 2026 and again on 7 August 2026, yet the matter remains unresolved.

The treatment was an emergency and was not planned. My mother required immediate medical attention and was therefore not reasonably able to first locate or travel to a Bonitas DSP/network provider. Despite this, Bonitas advised that the claims were not paid in full because the provider charged above the applicable PMB rate.

I have requested that the claims be reassessed taking into account the emergency circumstances and the PMB provisions relating to involuntary use of a non-DSP. I have also requested a proper explanation and benefit breakdown for a walker that was not funded because Bonitas claims there are "no funds available."

Bonitas has also stated that multiple attempts were made to contact us, which we dispute. Apart from a brief call on 24 July that disconnected before it could be answered, we have not received the alleged multiple calls or email responses.

After almost two months and repeated follow-ups, we simply want this matter properly investigated and resolved. I am requesting that Bonitas urgently reassess the outstanding claims, address the walker benefit and provide a clear written explanation for its funding decisions rather than another generic response.