1 reviews | Active since May 2016

06 Feb 2018, 07:11

Isn't the call centre supposed to assist me?

I called Camaf last year and again early January 2018 to enquire whether or not I am covered on my Vital package to see an Opthalmologist as I was looking into getting Lasik surgery. It was quite an extensive conversation both times with me enquiring re the proper ICD 10 codes etc etc. I was advised by the call centre person to go ahead and see the specialist which I duly did. R2600 later when I submit my claim (knowing full well that I would only be getting back the amount for the consult and not for anything else) I am advised by Camaf, NO, I am covered for none of the money of the money I spent. What an aggravation and unnecessary expenditure of R2600. What was the point of the time spent on the phone (twice)? It gives the impression of some weird type of set up where the doctors benefit, the medical aid doesn't care as it gets it's monthly stipend and I am left out of pocket of R2600. One big useless aggravation and waste of time. If I had just been told by the Camaf call centre operator - you are covered for nothing so if you want to see this specialist it is 100% for your expense, I would have rescheduled by 15 January 2018 appointment for a time other than January when, as we all know, the majority of us are running very low on funds. Big fat let down Camaf.

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Replies (3)
Camaf
Camaf's reply06 Feb 2018, 09:55
Official

Good day Natalie

Thank you for bringing this matter to our attention.

I am in the process of investigating this matter for you and will provide you with feedback once it has been resolved.

Kind Regards,

Caleb Brownley

Client Relations Team Leader

's update13 Feb 2018, 09:11
Reviewer Update
Camaf did advise they were refunding me a very small portion. Despite my ph call enquiries I have had no response from them advising when this refund will happen. Shoddy service
Camaf
Camaf's reply13 Feb 2018, 12:50
Official

Good day Natalie

The claim in question has been signed off by Management and has been sent to our Finance department who will make the payment.

As soon as the payment has been made, we will contact you and send you the proof of payment as well.

Kind Regards,

Caleb Brownley

Client Relations Team Leader