IP
Isabel P

1 reviews | Active since Jul 2013

27 Oct 2021, 13:50

BrightRock refuse to honour contractual agreement with client.

BrightRock refuse to honour contractual agreement with client.

During 2018 I send my cardiologist report to Brightrock to see if I have a claim.

I had stand alone benefits so a claim under one benefit will not effect a claim against another benefit.

1. I had cover under debt needs for Death cover 2. Stand alone from death cover I had under debt needs disability cover 3. Stand alone form death and disability cover under debt needs I have Additional expenses cover that you can recover from under premier max that can payout more than one's 4. Stand alone form death, disability cover under and Additional expenses cover that you can recover from under premier max I have additional expenses cover that's permanent under premier max that can payout more than one's

a) I was diagnosed with heart failure and cardiomyopathy with an ejection fraction of 34%. b) Both heart failure and cardiomyopathy is a cardiovascular disorder. c) I may only have a claim under point 2 and 4. d) so under point 4 additional expenses cover that's permanent under premier max that can payout more than one's according to the clinical definition I did not have a claim. e) Under point 2 under debt needs disability cover I had a valid claim. The clinical definitions applicable to my policy say as follow.

Any recognised cardiovascular or cardio-pulmonary disorder1 that results in the following cardiovascular assessments: New York Heart Association Functional Classification (NYHA) III /IV OR Ejection Fraction (EF) < 40% OR Metabolic Equivalents (METS) < 2

according to b) above Both heart failure and cardiomyopathy is a cardiovascular disorder. according to a) above I had an ejection fraction of <40%

So according to Brightrock's own clinical definitions I had a valid claim yet Brightrock rejected my claim.

0
Replies (1)
BrightRock
BrightRock's reply11 Jan 2022, 12:26
Official
Hi Isabel, our claims and legal departments have been in direct contact with you regarding this complaint. Kind regards, The BrightRock Team