1 reviews | Active since Dec 2016
Gems Government Medical Aid Scheme Extremely poor service
<p>MC Degenaar received an back operation (fusion) on the 27th of January 2016. After the operation the docter insisted that she must wear a brace for 3 months. The cost of the brace was R6480.00. The service was rendered by H Human practice number ********** . The claim was handed in to GEMS by him. In May the service provider contact the member and request that the money must be paid by the member. After receiving an motivation from dr J du Plessis who did the surgery we handed the claim again to GEMS. Up till today nothing has been done by GEMS. We called them numerous times and the call was escaladed 8 times already to the enuqiry devision by the call centre. On advise of the last call centre agent we send an email with reference number MH ********** 4 to the enuqiry centre on the 14th of December 2016. We also have an templete reference number given to us on the 14 November 2016 M.H. ********** 2. Main member: MC Degenaar Membership number: ********** 99</p> <p> </p> <p>Up to date we did not receive any response of GEMS. I think this is totally unacceptable andI can not understand that a company take nearly a year to sort out one claim. Totally pathetic. </p>
Good day
Thank you for alerting us to your claim concerns. We are looking into this and will provide feedback.
Kind regards
The GEMS online team
Good day
Thank you for alerting us to your claim concerns. We are looking into this and will provide feedback.
Kind regards
The GEMS online team
Still waiting for your response
Still waiting for your response
Again 48 hours passed without any response. Still waiting.
Again 48 hours passed without any response. Still waiting.
Good day
We can confirm that, as per our sms to you, we are in the process of resolving your complaint. Due to the account being older than four months, it is subject to the Scheme approval process.
We apologise for any inconvenience regarding this.
Kind regards
The GEMS online team
Good day
We can confirm that, as per our sms to you, we are in the process of resolving your complaint. Due to the account being older than four months, it is subject to the Scheme approval process.
We apologise for any inconvenience regarding this.
Kind regards
The GEMS online team
Thank you for your response. please take note that it is GEMS fault that the claim in older than 4 months. We have been struggling since May 2015 to sort it out
Thank you for your response. please take note that it is GEMS fault that the claim in older than 4 months. We have been struggling since May 2015 to sort it out
Again a month has passed without any clarification. Was promised two weeks ago that the claim will be settled last week Monday or Tuesday. wonder which Monday or Tuesday they speak about of which yea. Totally pathetic. Also said that they will phone me back to keep me updated, Not even a gost phones.
Again a month has passed without any clarification. Was promised two weeks ago that the claim will be settled last week Monday or Tuesday. wonder which Monday or Tuesday they speak about of which yea. Totally pathetic. Also said that they will phone me back to keep me updated, Not even a gost phones.
Good day
Thank you for bringing your concerns regarding your claim to our attention. As explained to you by the Scheme the brace is unfortunately not funded by GEMS and you are therefore personally liable to pay the outstanding balance to the service provider.
Kind regards
The GEMS online team
Good day
Thank you for bringing your concerns regarding your claim to our attention. As explained to you by the Scheme the brace is unfortunately not funded by GEMS and you are therefore personally liable to pay the outstanding balance to the service provider.
Kind regards
The GEMS online team
This is unaceptable. One of your media team told me the beginning of January that there is no problem, they will pay the money, the coming Monday or Tuesday in. It is a normal brace, we did an motivation from the dr, and gems rep**** that they will pay, it take time because it is an old claim. Can you please decide what you want to do. One person tells us that you are going to pay, next day another totally new person sends email telling us no.
No reason not to pay, normal brace for normal back operation. All the other medical aids pay, why not GEMS, it was in hospital. Please stop ignoring me and give me true answers I am again waiting two weeks after I ask that you must call me and explain.
This is unaceptable. One of your media team told me the beginning of January that there is no problem, they will pay the money, the coming Monday or Tuesday in. It is a normal brace, we did an motivation from the dr, and gems rep**** that they will pay, it take time because it is an old claim. Can you please decide what you want to do. One person tells us that you are going to pay, next day another totally new person sends email telling us no.
No reason not to pay, normal brace for normal back operation. All the other medical aids pay, why not GEMS, it was in hospital. Please stop ignoring me and give me true answers I am again waiting two weeks after I ask that you must call me and explain.
Still waiting for Aubrey to call as back as promised, more than a week gone by again, everyone at GEMS agree that they must pay, but nothing happen. PATHETIC
Still waiting for Aubrey to call as back as promised, more than a week gone by again, everyone at GEMS agree that they must pay, but nothing happen. PATHETIC