Delay on claims once again

Will someone call me today still? How long does it take to make a call and provide feedback?

Dear Lindiwe Mabizela, I called AGAIN this morning and insisted on speaking to a superior. I spoke to Lesedi ( Senior consultant ). She was kind enough to call the claims department. But what I found out is that my claim was last worked on 08th February, today is the 15th. My assessor Xolisile has still NOT CALLED. I pay R550 a month which is alot of money and what makes it worse is when we receive this type of service. The consultants can never call the claims department and all we get told is we will get an answer by close of business. Come close of business, there is NO RESPONSE and guess what.....we must wait for the next day because there is no contact at all. I don't think Clientele is being fair. When you guys need to sell your product or debit, that is done very quickly. I see that Clientele is reading comments but not replying. My number is ********** and if they do not get a hold of me, the alternate is **********

Dear Lindiwe, Thank you - they have now called. I honestly cannot believe the problem. Apparently there are 2 claims on my name from 22.01 to 31.01 and the other 22.01 to 30.01. If Claims called me initially, maybe this would of been clarified instead of it being dragged for so long and me going through extra trouble. My wife was admitted from 22.01 to 31.01. She has her own policy ( ********** 01 ) I am the payee. This claim was paid out already. My admission was from 22.01 to 31.01, I too have my policy ( ********** 35 ) where I pay. I cannot understand how this was mixed up. The assessor says there are 2 primary ICD 10 codes. That would be the case if Clientele used both hospital accounts on my name. The assessor has confirmed that its now been cleared and I should receive an answer soon. I have advised that I will check on Monday as this is a really silly error that did not take a genius to figure

Dear Lindiwe, I received a text message now stating if I'm unhappy with the decision I can contact the Ombudsman, reference supp**** CER540269. I called Clientele and the consultant says it's still under assessment. Why would I receive this text message if it's still under assessment? I need someone to call me immediately and have this resolved.

Dear Lindiwe, I received a text message now stating if I'm unhappy with the decision I can contact the Ombudsman, reference supp**** CER540269. I called Clientele and the consultant says it's still under assessment. Why would I receive this text message if it's still under assessment? I need someone to call me immediately and have this resolved.

Dear Lindiwe, That reply was last week. This is my reply of today, 18th February Dear Lindiwe, I received a text message now stating if I'm unhappy with the decision I can contact the Ombudsman, reference supp**** CER540269. I called Clientele and the consultant says it's still under assessment. Why would I receive this text message if it's still under assessment? I need someone to call me immediately and have this resolved.

Dear Lindiwe, Today Tuesday 19th February 2019 at 12h21, still no feedback. I stated I will call on Monday. This was yet another silly error on Clientele's side but the paying client needs to bear the brunt. I called about an hour ago and still told "under assessment". When will this end?

Dear Lindiwe, I see that you have not rep**** to my last comment. Anyhow, further to the above, when the assessor called last week to advise me of the problem I told her now that the error is cleared up, I will expect feedback by Monday. Prior to clearing up the error, she stated she will have an answer by Wednesday. Since Monday I called in, I was told the claim is still being assessed. Yesterday when I called in they said it's at final decision. TODAY I called in and got told it's still being assessed. I then asked to speak to the Team leader, Chantelle Chetty came on the line stating I WILL receive a call by 10h30 definitely. I did not receive any call so I called in at 11h00 and spoke to Donovan....who says Chantelle is not a Team leader and is on a call right now because its incoming call centre. Why do you take your clients for a fool??? Every single day I've been told its escalated....escalated where? Because certainly I am not getting feedback....its now 21 days later and this is RIDICULOUS AND PATHETIC SERVICE.

I want an answer or someone to call me on ********** or ********** immediately. Between my wife and I we pay just over R900 PER MONTH......for this type of service????

CLIENTELE IS BRILLIANT!!!! AFTER SO MANY WEEKS YOU NOW SAY PRE-EXISTING CONDITION. JUST BECAUSE THE AMOUNT PAYABLE IS ABOUT R20 000. IF ANYONE READING THIS GO DOWN TO PREVIOUS COMPLAINTS WHERE THEY DID THE SAME THING WITH MY WIFE WHEN SHE HAD A 33 DAY STAY IN HOSPITAL. CLIENTELE DOES NOT TELL YOU THAT THE MINUTE ITS OVER 5 DAYS, THEY FIND EVERY WAY NOT TO PAY OUT. YOU JUST TAKE OUR MONIES AS I CHECKED ON SOCIAL MEDIA AND THE COMMENTS AND REVIEWS ARE ALL NEGATIVE. IT'S STRANGE THAT YOU PAID OUT 2 CLAIMS ALREADY WHERE MY HOSPITAL STAY WAS ABOUT 4 DAYS AND NOW BECAUSE MY HOSPITAL STAY WAS 10 DAYS ITS A PROBLEM TO PAY OUT?

You guys are such ******* and I am not only going to the Ombudsman, I am taking this ALL OVER SOCIAL MEDIA. Every single social site I know of will hear this case. As mentioned I have proof even from my wife's repudiated claim. So I will let the country know of what to look out for when taking a policy with Clientele. You promise peace of mind but all we get is far more stress and worries.

MORE THAN R900 A MONTH IS MORE THAN WHAT ONE PAYS FOR LIFE INSURANCE. YET YOU TAKE THIS MONEY MONTH IN AND MONTH OUT BUT FAIL TO PAY OUT CLAIMS.

I am waiting for the repudiation letter so I can upload everywhere as proof. How long can this take?

I had initially put a complaint on the slow service and lack of feedback from Clientele. Clientele reported this to Hello Peter and the review was removed ( clearly there are others having the same issue and you did not want it shown. I then sent an email to Clientele directly AFTER some investigations on my side. This was sent on 24th February 2019. On 25th February 2019 I received a response from Joanna Motsamai stating "Dear Mr Naidoo I have forwarded your email to the Relevant Department. Feedback will be provided. ". To date, NOBODY has called me. Its Its going on 96 hours and still no feedback. I tnhink once again I have been more than patient - below is a copy of the mail. Dear Xolisile Hadebe, Based on your attached letter - I called Discovery myself to get proper dates, etc. According to your letter, I was diagnosed with Diabetes in May 2018 but Discovery says otherwise. I spoke to the pre-authorisation department and they sent me the letter, refer to MAY 2018 attachment. Furthermore I have been advised by Discovery that treatment for Diabetes started 22.06.2018. With that being said, I am at wits end with Clientele. Every single month I pay an amount of R 591.90, this is alot of money. You sat with this claim since 01st February 2019 and when I began calling in everyday I was told you last worked on it on 08th February 2019. I spoke to Lesedi ( senior floor consultant )......, then you called me to say you requested more information from Discovery. You also advised that the a claim was already paid out for admission from 22.01.2019 to 30.01.2019 for an amount of R 3300.00. I then told you that its my wife claim on a separate policy. You advised that the error is now cleared up and you will process same. You also PROMISED to have all this resolved by Monday 18th February 2019 and you would call me. Everyday since Monday 18th February 2019 I called and the same old story is said, "I see you called and escalated, the assessor will give you a call". Whether you were receiving the escalations and ignoring it,........beats me. I never received a call until WEDNESDAY 20th February 2019, when I commented again on Hello Peter and called, refused to put the call down, They then brought me Chantelle Reddy who said she was the Supervisor ( but I KNOW this is NOT TRUE ). So that is a lie one as we can never get to speak to someone superior. You then called to say "these are pre-existing conditions and its not a valid claim" - with alot of arrogance. So a little background, both my wife and I have SEPARATE policies with Clientele. I pay R 591.90 ( ********** 35 ) and she pays R 391.50 ( ********** 01 ) which is a total of R 983.40 ( thats more than what one would pay for life insurance ). If you look into the profile you will see that its been just 2 months now that she asked to use my account for the debit to go off, prior to that it was her account. Now I understand that you have done your investigations which you fail to send to me and asked me that I contact Discovery ( which I did ) and I received a different answer. Based on this, I would like to know where you got information that I was diagnosed with Diabetes in May 2018? Furthermore, I advised the consultant the reason my query and told her that Clientele states I was diagnosed in May 2018. She advised that there could be possibility of treatment, EXAMPLE. May 2018 I got admitted for a flu, when they ran blood tests my sugar was elevated, doctor asked if I had anything with extra sugar and I said yes, a monster energy drink. Now my sugar was high yes but did that mean I have diabetes??????? Another example is, you go to the doctor for a mere case of flu because you have a runny nose and pain. After check up doctor ALSO gives you a cough mixture as well ( as he knows that following you current symptoms you might start coughing ).......does this now mean you have PNEUMONIA? Based on the above, to enlighten you my wife had the same issue when her length of stay was 33 days in hospital. Clientele repudiated her claim stating it was a pre-existing condition ( same like mine ). After the whole process of providing proof, Clientele changed it to psychiatry. She was told flat out that if her stay was less than 10 days pay out would not of been a problem but due to it being 33 days, its very difficult to pay that amount. But moving forward, her claims were paid out thereafter......so what happened to the pre-existing condition. At that time my wife chose to leave it and lose out on payment for 33 days. You are more than welcome to check that out. Judging from this, my length of stay was 10 days and I can bet my life that Clientele has a problem with making payment, hence you finding reasons not to pay. Well, I have had enough of this and this time I cannot leave this. I will NOT lodge a case with the Ombudsman as I am fully aware that this goes in Clienteles favour because of payments. I have seen NUMEROUS complaints on Hello Peter, Facebook, etc and its not difficult to get into contact with the complainants. I see many similar stories like mine. If I don't receive proper feedback and get arrogance from you, I will get into contact WITH EACH AND EVERY COMPLAINANT, then start a campaign about Clientele. Once we get all the information and witnesses / victims, I WILL go to social media, newspapers, radio stations and SABC. I can supply all information in black and white. The false advertising Clientele does will be known as you STATE THAT YOU WILL HELP REMOVE THE FINANCIAL STRESS AND PRESSURE FROM HOSPITAL STAYS but instead you give us MORE GRIEF which affects us mentally. Please note that you can contact me on the same email address or these contact numbers ********** or **********