WS
Wendy S

1 reviews | Active since Feb 2019

02 Nov 2020, 14:03

ELEXI THE WORST IN EVERY WAY!

If you want a medical insurance that is CHEAP, are NOT ACCEPTED by most doctors, radiologists or pharmacies, does not REPLY to emails, has many DELAY TACTICS, does no give you the cover you PAY for, does not help you when you need an EMERGENCY operation caused by an ACCIDENTAL INJURY, does not send MEMBERSHIP CARDS and makes you wait for months to get a list of contracted DOCTORS then you found it! I tore two ligaments and after SEVERAL emails over the last 19 DAYS I still have accomplished NOTHING but that they MAY pay after investigating it (and I send several documents, reports and explanations) Maybe they will pay R6000 for an R80 000 to R100 000 operation. One of the issues are that I did not have the surgery immediately (the hospital that was on their provider list was on leave and the only one that does ankle surgery) I asked them on the 15th if they would pay for the operation. I saw the specialist on the 16th and now they want a report for the GP that attended to me the first time (another delay tactic) they have the sonars and the report thereof. I dealt with Janis Pillay and it was the worst (non) service I ever received. The specialist will only do the operation if Elexi pays UPFRONT (clearly the practitioners also dont trust them) And all of this for maybe R6000 after walking g around with two torn ligaments for weeks. RIDICULOUS! Please don't waste your money by joining them. Rather throw it in the toilet. What a ****!

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Replies (2)
Elixi
Elixi's reply02 Nov 2020, 14:28
Official
Dear Wendy

Thank you for reaching out to us.

Your query has been forwarded to our customer support team for further assistance and they will be in contact with you shortly to discuss the matter further.

Regards
Elixi team
Elixi
Elixi's reply12 Nov 2020, 16:44
Official
 Dear Wendy  Thank you for allowing us the opportunity to look into the matter.   Kindly note that we attempted telephonic contact with you however to no avail, communication of our attempts to reach you was also sent by SMS and email.

We have reviewed our records and would like to share the following feedback:  The Insurer received your enquiry on the 15-10-2020 and which was later reviewed on the 19-10-2020 upon the membership number being provided. by yourself. The request for surgery due to a torn ligament was received and reviewed and it was established that no authorization was provided nor any call logs indicating an accident or injury. The service provider later discovered that these injuries were sustained while doing household c****s.  With reference to your policy document, you have access to a casualty benefit and pre-authorization is required prior to accessing the benefit. This process was not followed and the service provider has no record to the nature of the injury, the service provider required a report from the doctor who first attended to you following the injury to make a funding decision. The records have be viewed and after several requests, no report was received.  Kindly provide us with the requested report for a funding decision to be made by the service provider.  We trust that we have been of assistance to you.

Regards
Elixi team