1 reviews | Active since Jan 2013
Not paying out a Pre-authorised GOP
Please post a link to the declaration in the contract or on your website that confirms that Essential Med does not pay out a passengers medical bills in a case where the driver has a learner license. As I would never have taken out this medical insurance if this is the case and will advise other citizens not to do so either! <br> Do you also decline pay outs to patients that are ill in hospital on the terms of them living an unhealthy lifestyle or eating the wrong foods? Or in a case where a patient was shot and the shooter does not have a legal gun license?<br> My daughter's pay out was declined after Pre-Authorisation was approved! Due to the fact that the driver only had a learner license. My daughter was a passenger and unaware of this as she lives in Cape Town and is not a friend of the driver. She is the victim in this scenario and you decline pay out to a passenger on grounds of this?<br> I will also make this known to the public as mentioned above! This is not a medical scheme or insurance I want to invest in or anybody else should! <br> <br> Lemanja Davidson, writer / reporter Locum Lifestyle Magazine<br> <br> [URL Removed] <br>
Thank you for bringing the concerning matter to our attention.
As you stipulate the driver of the vehicle did not have a valid driver's license. The following documentation was requested from you as client:
Accident report,
Valid driver's license as well as the casualty report.
Once the requested documentation is received then the claim will be submitted for processing. Thus being said is not confirmed that the claim is valid to be paid. We investigated the matter and discovered when the requested documentation was received from the Lawyers that the driver got his license on the 15th of January 2016. Therefor the claim is repudiated. In your previous complaint you stated \my daughter was on holiday caught a lift with a friend who (driver) since hired a lawyer to protect himself and they don't want to send through this information as he is protected under the law! \"
Thank you for bringing the concerning matter to our attention.
As you stipulate the driver of the vehicle did not have a valid driver's license. The following documentation was requested from you as client:
Accident report,
Valid driver's license as well as the casualty report.
Once the requested documentation is received then the claim will be submitted for processing. Thus being said is not confirmed that the claim is valid to be paid. We investigated the matter and discovered when the requested documentation was received from the Lawyers that the driver got his license on the 15th of January 2016. Therefor the claim is repudiated. In your previous complaint you stated \my daughter was on holiday caught a lift with a friend who (driver) since hired a lawyer to protect himself and they don't want to send through this information as he is protected under the law! \"