OO
Octavia O

1 reviews | Active since Sept 2014

02 Mar 2018, 12:09

hospital and dread disease claim

I join clientele help plan 2014 July my policy no- ********** 14 for my mom at 63 yrs old , my mom got sick and when I took her to doctor they say its stroke she is supposed to be hospitalised then I called clientele on the 21 Feb '18 I spoke to Tiro Moremi I explain my situation wanted to claim for hospitalisation and dread diseases as the cover includes both , that's were I got a shock in life he said I cant claim for dread diseases as my mom is over 60 yrs it doesn't cover for 60 and above but I join the cover while she was 63 and they never told me about age and every month they deduct money for the cover for almost 4 yrs now , I explain to him I was never told about age restriction when I join the cover he said he will lodge a complain and I was given ref CER 499724 , then today 02 March my mom has been discharged from hospital I call clientele I spoke to Kluhana she told me that on dread diseases they give period of 14 to survive if a person survive that 14 days they don't pay meaning my mom was supposed to die in order for them to pay then she transferred me to her sup her name is Helena , every time I called I got different story as I called more than 5 times in 1 week row and when i talk to Tiro he said my mom was supposed to get R13900 .00 if they approved , but when I called again following day after I spoke to Meiki she said it will cover for R11900.00 each time I get different story from consulted , really this is a day light ******* from clientele after paying for 4 yrs when I claim I got different stories .

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Replies (4)
Clientele Life
Clientele Life's reply05 Mar 2018, 08:56
Official

Thank you for raising your concerns with us.

Your query has been escalated to the relevant department for investigation and we will be in contact to assist you further with the matter.

Yours sincerely,

Shanitha Hanuman

Service Recovery Supervisor

Clientele Life
Clientele Life's reply09 Mar 2018, 16:57
Official

Dear Octeym

Thank you for raising your concerns and bringing this matter to our attention.

At the outset we would like to apologise for any poor service that you might have experienced in the notification process of your claims. This is not the level of service we aim to provide our clients and we assure you of our best intentions.

We confirm that both your Dread Disease and Hospitalisation Claims were loaded and are being assessed. Our Claims Assessors were in contact with you regarding the claims and confirmed the outstanding documents needed in order for us to finalise your claims.

Should you require any further assistance in this regard please feel free to contact us again.

Kind regards,

Claims Department

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Octavia O's update15 Mar 2018, 07:55
Reviewer Update
Good day all I would like to express my disappointment and bad service at clientele I took a hospital help cover 01/07/2014 for my mom , unfortunately my mom sick got diagnosed with stroke and she was admitted to Tambo Memorial Hospital from 21/02/17 -02/03/18 I made a claim with clientele for hospital day to day and dread diseases . on the 21/02/18 I asked for policy documents with I never received any since I joined this cover I checked all paper was surprised to see many amendments while when I join this I was never told some of the things that are written there since I joined telephonically ,today at 01:54 am I got paid for hospital day-day cover I don’t understand how did they calculated because they paid R12251.43 and to my understanding the documents where send to me clearly states that’s daily cash benefits its R2382 and when you do calculation for R2382*9 days its R21438 and the issue of dread disease is still unsolved.
OO
Octavia O's update03 Apr 2018, 13:40
Reviewer Update
good day I'm still waiting for payment of dread disease for my mom since I made claim February till date nothing for policy no - ********** 14 ref SO133584