RH
Ruxana H

1 reviews | Active since May 2021

20 Mar 2024, 10:19

Dis-Chem Health Insurance

My husband has a health insurance policy - he fractured his hand so received authorisation to go to a certain hospital on a Saturday. He went to casualty and the doctor attending to him did x-rays and tried calling the orthopedic surgeon. Surgeon was not available so they asked hubby to go see the surgeon on Monday. Come Monday, we arrive at the specialist office, only to be told we require authorization. So we call Dis-Chem Health and the call centre agent says we must visit a GP on their panel to get a referral to the specialist. After a lot of back and forth, they eventually approve the specialist visit. Stemming from this visit, the specialist recommended surgery which was initially approved. We made arrangements for the surgery to be done the next day and 3 hours later, towards the end of the day, we were informed the request was then declined. Since then I have been trying to contact them and the only way to liaise with their escalations department is via email. I sent an email yesterday afternoon and still await their response. I contacted the call centre this morning and after speaking to them for 30 minutes, I was told their supervisor, Thabiso and people from the escalations department will call me back immediately. An hour later, still no call. I did call them back and no-one can help me nor can they give me a contact person to call directly. Thabiso is still not available. My question is, what happens if this was a serious emergency? Do we die waiting for help? In the meantime, hubby is sitting with a serious fracture, waiting on the people in the escalations department to respond to my email. So every minute they delay, the full use of his hand is being compromised! Utterly inhumane service - will never recommend this insurance to anyone.

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Replies (1)
RH
Ruxana H's update22 Mar 2024, 09:11
Reviewer Update
22 March 2024 - 8.53 am
Received an email on Wednesday (10.48am) with the following:
"Please note that we acknowledge the receipt of your complaint and we are currently investigating.
We will revert back shortly with a final outcome."
At 2.48pm, no response received so I sent a follow up email which was ignored.

I called this morning and was told Demi from the escalations dept is trying to call me (no call received) and she will call me back immediately. She did not call me but sent me another email with the following:

"Kindly note that this is an ongoing investigation, and we will provide feedback once we have an outcome for this case.
We hope the above is found to be in order. "

I rep**** via email asking her to call me as we can then try to resolve the query quicker. Am still waiting but don't think I will receive a call. Have given up on that.

As all calls are recorded, I will request for them to review my calls and then take it up further. They will clearly see how many times I have been **** to, especially with regards to them promising to call back and not doing so.

So my question to these schemes is, why is it so difficult to speak to the escalations team? It is frustrating to be stone-walled by the contact center each and every time!!! PLEASE DO BETTER.

Has anyone else experienced similar problems? Please do share.

I will be sure to post regarding the outcome of this matter.