jK
johan K

1 reviews | Active since Mar 2015

26 Nov 2017, 21:15

POOR SERVICE

I am a member of your medical insurance specifically the hospital plan from the first of January 2015 This is the first time that my son needs to go to the hospital for extraction of his wisdom teeth. We send a motivation letter due to danger to inferior alveolar nerves and maxillary sinuses, Acute pericoronits and cellulites around tooth 38. This was declined. We dont know why, When we took out this hospitalplan nobody told us that certain things will be excluded. Are you not suppose to give us all the info so that we can decide if this is the plan that we need. So for almost two years we are paying for this medical without any claim and now that we need it you declined it. Your call centre phoned me some time ago and asked if we are still happy with the plan we confirmed and told them that we didnt have a claim yet and cant tell them if this is a good medical aid. I am not happy with the way I was treated and I want an explanation, I dont want to pay for a medical insurance that I thought will pay for my childs operation and now dont want to do this. Your staff that is marketing this product are they not suppose to tell the client everything , I am paying for two years for a medical that is not helping me at all. Please investigate. I need answers and my premiums back. Looking forward hearing from you

0
Replies (4)
EssentialMED
EssentialMED's reply27 Nov 2017, 09:41
Official

Good day,

Thank you for bringing your concerning matters under our attention.

The hospital cover that you have on your policy is for Illness, Maternity, Accident, Dread Disease and Permanent Disability. No dentistry is covered in hospital as it is a day procedure and the hospital cover do not offer dental benefits.

Essential Med strives in the best service delivery towards all our valued clients.

Kind regards,

Essential Med

Best regards,

jK
johan K's update27 Nov 2017, 18:42
Reviewer Update
If you look at the motivation letter it is not a day procedure. Why was this not explained to us when we took out this so called medical insurance. How can you say it is a day procedure. Why didnt you call us. as we asked for tthat. This is a *******. Dont send me an automated reply. Look at the bigger picture. I am so disgusted in your service. I need proper answers.
EssentialMED
EssentialMED's reply28 Nov 2017, 08:12
Official

Good day,

Thank you for bringing your concerning matters under our attention. A consultant will be in contact with you before close of business today.

Kind regards,

Essential Med

Best regards,

EssentialMED
EssentialMED's reply28 Nov 2017, 11:05
Official

Good day,

We would like to confirm that Elize was in contact with you and explained the hospital admission procedure to you.

The complaint was resolved.

Kind regards,

Essential Med

Best regards,