Pathetic

I logged a claim with the gap cover, for a procedure I had done in May. First it took them 2 weeks to have a look at my claim, the minute I escalated my claim they decided to advise me that I have a pre-condition. When asked to name the condition since my Dr has not I was advised to check my policy documents for the escalation department details, I emailed and still this person decides to refer me to my policy documents. They have no contact details on thier signatures, they use a generic email address to respond because I guess their direct email and co tact numbers belongs to them personally. Now I have copied an email below from your pathetic consultants and I want this escalated to the highest. I send a motivational letter from my dr and yet that wasn't good enough. I lost my dad during all this and still had to get this response from you? On Fri, 28 Aug 2026, 10:37 Auth, <***> wrote: Good day,

Thank you for your email.

Please note that all relevant contact details are included in the wording documents that were provided to you when you joined the policy.

Thank you for your understanding.

Kind regards,

Vivian Mathabatha Care Co-ordinator Netcare Limited

Switchboard:

Direct Number:

Mobile:

E-mail:

***

Website:

www.netcare.co.za

From: Candice Vanrayne <***> Sent: Thursday, 27 August 2026 17:50 To: Auth <***> Subject: Re: Letter of motivation--***8

ALERT: This message originated outside of Netcare's network. Please be additionally cautious before clicking any link or opening attachments.

Good Day

Kindly provide me with th contact details of your complaints department.

Email and direct contact number.

You cannot name my condition yet you can deny my claim.

So no don't refer me to my policy document because your signatures doesn't even have contact information.

So I would appreciate you take your time to provide me with such. Since you are medical professionals.

On Tue, 25 Aug 2026, 09:48 Auth, <***> wrote:

Good day,

Thank you for your email.

Please see the attached communication, which was previously communicated to you.

Please note that our decision remains unchanged.

You are welcome to follow the complaints process outlined in your schedule/policy should you wish to take the matter further.

This case is considered closed on our side.

Kind regards,

From: Candice Vanrayne <***> Sent: Monday, 24 August 2026 16:01 To: Auth <***> Cc: Gap Claims <***> Subject: Re: Letter of motivation--***8

ALERT: This message originated outside of Netcare's network. Please be additionally cautious before clicking any link or opening attachments.

Good Evening

Please can you provide me with a response to my email below?

Since you advised that it's a pre-existing condition kindly provide me with the name of my condition.

Am I not correct in saying that a condition should have a diagnosis which obviously has a name to it? For example lupus, MS, scoliosis and etc??? I was never given a diagnosis by my dr. So I would like to raise this concern by taking it take this matter further with HPCSA.

Awaiting your response.