NM
Nokuthula M

1 reviews | Active since Sept 2025

16 Sept 2025, 10:45

Unfair Decline decision

I want to report FNB in the hospital insurance department. They declined my claim due to no medical evidence but according to the hospital file and medical report claims from, they both correspond to show that indeed there’s sufficient medical evidence and information for the claim to be approved. When I talked to the consultant today called Siya, he told me a wrong diagnosis captured on the system that was not on my medical reports (Hospital Reports and Doctors Medical Report claim form). He kept on insisting that nothing can be done because that’s what it is written by the assessor. The assessor has not gotten back to me.

The accessor that was working on my claim and declined it didn’t not bother to call or email me. The claim was declined on the 9th of September but I called on the 10th and the 11th but still I was told they are still working on the claim. I called again on Saturday the 13th of September, that is when I was made aware that the claim was declined a few days ago without any correspondence. How is that possible? Help me!

0
Replies (0)