ER
Elna R

1 reviews | Active since Jun 2012

28 Feb 2025, 22:16

STAY AWAY IF YOU DON'T HAVE MONEY TO WASTE!

No! No! No! No! STAY AWAY!! I am paying R1600 a month for myself and my husband, starting date December 2024. 1.) When I took out the Policy in November 2024, I WAS NOT TOLD that heart attacks and strokes were excluded, because.... A MONTH LATER I am refunded the portion of THE PREVIOUS MONTH's DEDUCTIONS for these two conditions!! [clearly this medical insurance realised that their little basket full of golden eggs were going to be affected because with the stress in this Country these two things are happening more and more often!!]

2.) Then it became interesting.... I wanted to have blood works done. Now flippen humor me..... They will PAY the GP their consultation fee in full, for me to visit them; THEN they will pay (in this case Lancet) for the blood tests, seperate service provider, seperate bill! But..... I CAN NOT just go to Lancet and have the tests paid for, UNLESS I go to one of THEIR specified doctors??!! 3.) I was so desperately ill beginning of Feb. 2025 that I simply did NOT have the energy to fight about who, what, where, what not etc. I went straight to Helen Joseph..... Diagnosis: PE I was discharged last Friday!! DID ANYBODY INJURE ME ON PURPOSE???!! Hell no!! I was treated very well and professionally. Unfortunately, I did have a complication and ended up with a hematoma!! Now, I have the calmness after the storm, I can think clearer, I can cope and be patient.... 4.) Hence, this morning I phone my beautiful Medical Insurance requesting advise on what to do..... the lady suggested, without hesitating, go to Wilgeheuwel, let them get pre-authorisation and take care of you!! I phone Wilgeheuwel to make sure that Dischem will cover all, the person on the phone also suggested, just get here! We will get the authorization!! Get to Wilgeheuwel, start filling in all kinds of papers, they phone the insurance; low and behold - the man on the other side of the phone wants to speak to me.... I explain to him, as a result of the clexane, these ACCIDENTS DO HAPPEN, and sometimes complications is the end result. Then he ask me: "So, you came to hospital cause you have ****les on your stomach?" Well..... I NEARLY LOST MY COOL!! DO YOU EVEN KNOW WHAT A HEMATOMA IS?? And he says yes, blood. But eish SORRY NE, THAT IS NOT COVERED!!! I explained that this was an ACCIDENTAL MEDICAL EMERGENCY??!! No, it's not!! PE is COVERED, yet THIS ACCIDENT, which is an indirect result of treatment for the PE is not covered!! 5.) Nothing is more embarrassing and belittling that having to walk the walk of shame out of a place, because the (let me just call you) PEOPLE who claim to have your back ..... WILL ASSURE THAT NOTHING IS COVERED AND NO CLAIMS ARE LEGIT!!!!! 5.) YOU ARE A DISPICABLE, SHAMELESS BUNCH OF SHARKS, with NO regard for human life or the well being of patients!!!! And DON'T YOU DARE patronise ME, with one of your smooth talking marketers commenting "We are so sorry..... blah-blah blah-blah" BECAUSE YOU ARE NOT!!!!!!!!!!!

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Replies (1)
Dis-Chem Health (Medical Insurance & Gap Cover)
Dis-Chem Health (Medical Insurance & Gap Cover)'s reply01 Mar 2025, 11:55
Official
 
We're sorry to hear about your experience, Elna. We understand how frustrating this may have been. We assure you that we have taken the necessary steps to resolve this matter, and we will be in contact as soon as possible.