4 Months of Empty Promises – GEMS Still Hasn’t Refunded Me!

I am absolutely disgusted with the service I’ve received from GEMS Medical Aid Scheme. For the past 4 months, I have been trying to claim refunds for doctor’s visits that are clearly covered under my day-to-day benefits, yet GEMS continues to fail to pay out a single cent.

Despite multiple claims submitted, and numerous phone calls and emails, I am met with the same runaround every time:

First, I’m told my documents are all in order and payment will be processed.

Then suddenly, GEMS claims they no longer have the documents on file—documents they previously confirmed as received.

Every time I call, I’m told that my FICA documents have been updated and I’ll be refunded on the next payroll.

Other times I’m told the money has already been paid out, yet no proof of payment is provided, and I have not received a single cent.

This isn’t a delay — this is blatant incompetence and deception, if not outright theft. Logging transactions as “paid” when no funds ever reach the client’s account is *****ulent and *********.

At this point, I am escalating the matter to the Medical Ombudsman and will be lodging a formal complaint. You cannot continue to exploit members who rely on your service during times of medical need. People’s health and finances are not a game.

I demand immediate resolution, proof of all supposed payments, and settlement of all outstanding refunds without delay.

GEMS – you have lost my trust entirely. If this isn’t resolved promptly, I will also consider legal recourse. Enough is enough.