Its a mafia

Considering you get R8000pm month one does expect better.

This past year twice have you declined claims. Both those claims have been advised and motivated by ACTUAL, REAL specialists that attended to my wife and daughter.

But no, the faceless and nameless so called "Clinical Review Team" knows better than the attending physicians.

Nevermind trying to actually speak to these so called Clinical review panel members. Nope, sorry you cant speak to them. Can`t phone them, email them or get a meeting with them.

But make no mistake they know better about your situation that an actual doctor. That begs the question, are they actual doctors these so called panel members? Or is it just a clerk with a tick list? Why so secretive?? Why cant I speak to the person that makes a decision about my health??

Fun fact people, your own doctor cant speak to them either! Nope, your doctor needs to speak to a callcentre agent. Of course that callcentre agent has the same level of training as a specialist.

Of course when they decline your request the siting the secretive "scheme rules". To date, nobody has been able to supply me with these "scheme rules". After almost a year I finally found it on the website. Problem is, we aren't doctors or lawyers so its a nice comfortable screen for them to hide behind. Of course its completely reasonable to expect a client to in a moment of panic whip out the scheme rules find the relevant section and give that to the emergency room doctor. Makes complete sense!

My favorite this past week is when they claimed to me they didn't receive certain documentation......but it was sent to you numerous times. But wait, I see the problem. You are only allowed to deal with the callcentre agent so they cant actually help you. But here is a reference number for your trouble

They try make us feel better with Vitality and all kind of specials....its bull**** window-dressing.

The joke is the doctors are just as frustrated.

Its a mafia where decisions are made in secret and we pay for it crossing our fingers hand hoping they will help us when we need it.

Lets see if an actual person with actual decision-making power will contact me.

Ridiculous