Delay Tactics used to not pay and try and avoid the Ombudsman.

I have been with Essential Med for a year now and have tried to put in my 1st claim. When I called in I was told straight away that they would not pay. I had a look at the policy and did not agree with their denial and informed them that I wanted to approach the ombudsman. It has now been a week and I have called in multiple times asking for a repudiation letter but as yet have not received anything.

I believe that they use delay tactics in the hope that problems will go away, similar to an ostrich hiding its head in the sand.

I have finally spoken to a manager, Elize, who cannot help right now (another delay tactic?) and has asked for a lot more additional information which I was never made aware of before hand even though I asked on multiple occasions that my case be brought to the attention of a manager (delay tactic), she would not take the information over the phone and insists it be put in an email (delay tactic).

My advice to anyone who needs to repudiate a claim is to call in multiple times a day, ask to speak to a manager and definitely take it to the ombudsman.

Essential Meds policies are seem weak and are poorly worded, this is not to their advantage. It is not the clients responsibility to make the policy clear, it is up to Essential Med to word their documents and policies clearly and not make them ambiguous.

I would also like to mention that it is my belief that the only reason Essential Med has positive reviews is because they ask for it when you sign up and before you receive your welcome pack.