Pathetic service

Follow up on Claim reference number ***

Spoke to Sbahle who was not willing to understand my query, after talking to her for a very long time and long hold I requested to be transferred to a Team leader however she transferred me to another consultant by the name of Janie. I insisted on speaking to a supervisor but they put me on long hold again

I would like to dispute your response to my recent claim received on the 05/08/2020 Membership no: ***

On the 31/07/2020, I sent you a claim for the payment that was made to the doctor on that same day . The payment was for Simphiwe Mgoboza’s visit to the doctor on the 15/06/2020 I attached Doctor’s statement showing consultation date and amount as well as the date of account settlement of R980.00

On the 07/07/2020, I made a claim from you for the payment to R1000.00 that I paid the doctor on the 04/04/2020. This payment was for Simphiwe Mgoboza’s hospital consultation on the 18/10/2019. I paid the doctor very late as I didn’t have money to settle my account in October 2019. Payment to the doctor was done on 04/04/2020 as per attached proof of payment This is a claim I sent to you on the 07/07/2020 and received a refund of R637.50. Payment date 07/07/2020.

Yesterday I received response to my recent claim sent to you on the 31/07/2020 stating that the refund I received on the 07/07/2020 was for Simphiwe’s consultation on the 15/06/2020. How possible is that you can refund me before I made payment. How can you refund me on the 07/07/2020 for the payment I only made to the doctor on the 31/07/2020

• Refund received on the 07/07/2020 of R637.50 was for the payment of R1000.00 paid to the doctor on 04/04/2020 (see attached, doctors statement and proof of payment), • Claim sent to you on the 31/07/2020 is for the payment of R980.00 paid to the doctor on 31/07/2020 (see attached, doctors statement and proof of payment)

All necessary documents are attached as follows  Your feedback received 05/08/2020 regarding claim made on the 31/07/2020.  Doctors statement for the amount of R1000.00 for my son’s Hospital consultation on 18/10/2019 with payment reflecting settled on the 04/04/2020  Proof of payment of R1000.00 paid to the doctor on 04/04/2020  Doctors statement for the amount of R980.00 for my son’s consultation on 15/06/2020 with the payment reflecting settled on the 31/07/2020  Proof of payment of R980.00 paid to the doctor on the 31/07/2020

I copied and pasted details on my claim no: *** - all attachments to be checked on this reference number

Your prompt response will be highly appreciated

Regards Ruth ***