HM
Herman M

1 reviews | Active since Jan 2025

10 Jan 2025, 09:51

They do not pay claims

My son was born on the 16 of September and had to spent a few days in hospital. My wife and I are on separate medical aids and we discussing which medical aid my son should fall under. As the father, I decided that it would be best for the child to be on my medical aid. Before coming to any conclusion, I called Fedhealth to confirm if my son's hospital stay would be covered, the representative assured me that the hospital stay would be covered, because of the 30 day grace period after birth. When it was time to payout the claim, Fedhealth informed me that they would not pay out because the hospital stay was not authorised. If I had this information beforehand, me and my wife would have decided otherwise. I have been misled by the fedhealth representative to make a decision that is not in my best interest. Now I am stuck with a medical bill that would have been paid out if my son was on my wife's medical bill. I will be reporting this misrepresentation to the ombudsman.

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Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply14 Jan 2025, 12:31
Official
Dear Member,
 
Thank you for submitting your feedback to us, we are sorry to hear about your experience. One of our consultants is already attending to your request and will respond to you shortly. 
 
Best wishes,
Fedhealth