1 reviews | Active since Nov 2015

23 Dec 2015, 10:11

Not honoring the contract

My son was hospitalized on 15th of October 2015 to 21 October 2015, We conducted clientele as our insurer then they asked us to send the documents (Medical certificate, Dr's reports, test results, etc) which we sent on 3rd of November 2015. Follow-up was made with Zukiswa and Nicholas hence they couldn't give me a concrete feedback hence she (Zukiswa) promised to ask Nicholas to call me back, since then I was moved from pillar to post until today (16/11/2015) when I phoned Nicholas.<br> <br> As per our telephone discussion he confirmed that they are not going to pay my claim because he test results didn't reveal that my son had a disease which the doctor thought he had hence the policy didn't stipulate that they will not pay if the patient is not diagnosed with disease which the doctors thought it was, hence the POLICY STATE THAT IF A PATIENT IS HOSPITALIZED FOR MORE THAN 3 DAYS THEY WILL PAY!!!!!<br> <br> Few weeks ago (09 December) they requested the medical file from hospital in order to review it hence they still came to the same resolution, what constitutes them not honoring the contract as advertised in the media or are they one of those insurance companies that tell the masses one thing

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Replies (1)
Clientele Life
Clientele Life's reply23 Dec 2015, 10:44
Official
Hello Lesibe0890,

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 shortly.

Your sincerely,

Benita Steyn
Service Recovery Specialist