1 reviews | Active since Jul 2011
LAW INTO THEIR OWN - *****
<p>I took out a Hospital Plan with Cliente in October 2016. On around 14 October 2016, I removed my wife as a beneficairy and nominated my daughter as a beneficiary. Cleinte then removed my son who was on as a member. They ADMITTED THAT THEIR EMPLOYEE REMOVED MY SON IN ERROR.</p> <p>I have been paying for both of us since the inception of this policy. According to Clientele, they cannot reinstate him as it is law since April 2017 as there is a "demarication legislation" which they cannot tell me waht this means.</p> <p>Now Clientele wants to refund my all my premiums. ITS NOT MY ERROR - ITS IS THEIR TOTAL IMCOMPETENCE AND THEY HAVE BEEN DEDUCTING FOR BOTH OF US AND IS **********</p> <p> </p>
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,
Benita Steyn
Service Recovery Specialist
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,
Benita Steyn
Service Recovery Specialist
Thank you for raising your concerns with us.
Whilst we acknowledge the oversight of removing your son , we must state that the original premium was reduced when your son and spouse was removed from the policy. We therefore confirm that premiums were not paid, for your son since November 2016 to date and we have no records which indicate that this was queried by yourself.
As per our discussion we acknowledge the oversight of removing your son, unfortunately we are not in a position to add him back onto to the policy as we are governed by legislative changes.
It is important to note that the demarcation regulations were issued by the FSB as per Government Gazette 40515 on 23 December 2016 with an effective date of 01 April 2017 which aimed to clearly define the difference between what medical aids and insurance companies can offer.
The Demarcation framework as published by National Treasury and the FSB specifically states that as from 1 April 2017, no variation may be made to a health insurance policy that came into effect before the 1st April 2017. As from the 1st of April 2017 any variation to a policy must comply with the demarcation legislation and organisations are obliged to duly comply.
The demarcation legislation confirms that clients who have existing Clientele Hospital Plans can continue with their policies however, no changes can be made on existing plans.
As per request a detailed written response was sent to the email address we have on record.
We would like to take this opportunity to apologise for any inconvenience caused in this regard.
We trust you find the above in order however, should you require any further assistance please do not hesitate to contact us.
Yours sincerely,
Shanitha Hanuman
Supervisor
Client Services – Service Support
Thank you for raising your concerns with us.
Whilst we acknowledge the oversight of removing your son , we must state that the original premium was reduced when your son and spouse was removed from the policy. We therefore confirm that premiums were not paid, for your son since November 2016 to date and we have no records which indicate that this was queried by yourself.
As per our discussion we acknowledge the oversight of removing your son, unfortunately we are not in a position to add him back onto to the policy as we are governed by legislative changes.
It is important to note that the demarcation regulations were issued by the FSB as per Government Gazette 40515 on 23 December 2016 with an effective date of 01 April 2017 which aimed to clearly define the difference between what medical aids and insurance companies can offer.
The Demarcation framework as published by National Treasury and the FSB specifically states that as from 1 April 2017, no variation may be made to a health insurance policy that came into effect before the 1st April 2017. As from the 1st of April 2017 any variation to a policy must comply with the demarcation legislation and organisations are obliged to duly comply.
The demarcation legislation confirms that clients who have existing Clientele Hospital Plans can continue with their policies however, no changes can be made on existing plans.
As per request a detailed written response was sent to the email address we have on record.
We would like to take this opportunity to apologise for any inconvenience caused in this regard.
We trust you find the above in order however, should you require any further assistance please do not hesitate to contact us.
Yours sincerely,
Shanitha Hanuman
Supervisor
Client Services – Service Support