1 reviews | Active since Nov 2017
poor service
Hi im lingavani naidoo...my id number is ********** 174089. 7 months ago i took out a hospital plan with clientele. My policy number is ********** 61. I was admitted to hospital on the 8-10-17 and got discharged on the 12-10-17 at first when i got admitted the doctor in the trauma unit suspected it was kidney stones so i was reffered to doctor H hussain a urologist when my bloods were done my wbc was raised and i was put on intravenous antibiotics i was also sent for a CT ABDOMEN when the urologist saw the results he then reffered me to a surgeon DR A G NAIDU i was then diagnosed with PID PELVIC INFLAMMATORY DISEASE. I had given al the necessary documents on the 30-10-17 on the 09-11-17 i recieved a call from clientele telling me that the claim was declined because i didnt have a final diagnosis....when i explained to the lady that she need to check with the surgeon cause he was attending to me she said that she is sorry when i said i was unhappy and would like to cancel she was so happy to put me through to the cancellation department i do have the terms and conditions and it doesnt state that if you donot have a final diagnosis that your claim will be declined....please help
Thank you for raising your concerns with us.
Your query has been escalated to the relevant department for further 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 further 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 and bringing this matter to our attention.
At the outset we would like to apologise for any delays you might have experienced in the assessment of your claim. This is not the level of service we aim to provide our clients and we assure you of our best intentions.
We confirm that our Claims Assessor (Bulelwa Mhloli) was in contact with you regarding this claim, and confirmed our decision based on all clinical evidence submitted to us.
Radiology report and Urine MC+S were normal for the investigated final diagnosis.
As per pathology diagnostic standards, mild elevation of Leucocytes does not indicate pathophysiology.
Should you require any further assistance in this regard please feel free to contact us again.
Kind Regards
Claims Department
Thank you for raising your concerns and bringing this matter to our attention.
At the outset we would like to apologise for any delays you might have experienced in the assessment of your claim. This is not the level of service we aim to provide our clients and we assure you of our best intentions.
We confirm that our Claims Assessor (Bulelwa Mhloli) was in contact with you regarding this claim, and confirmed our decision based on all clinical evidence submitted to us.
Radiology report and Urine MC+S were normal for the investigated final diagnosis.
As per pathology diagnostic standards, mild elevation of Leucocytes does not indicate pathophysiology.
Should you require any further assistance in this regard please feel free to contact us again.
Kind Regards
Claims Department
