Joke of a medical aid

Service date 07 January 2022. The claim has been submitted 5 times by myself and the doctor. I have followed-up on the unpaid claim at least twice a month. In June 2022 alone I have called over 4 times take note, it is only the 20th of June 2022 Excuses for not making payment •There is no authorization number (yet I have a letter on a letterhead from Gems with the authorisation number) • The doctors practice number is incorrect • This claim has been approved for payment, we don’t understand why it hasn’t been paid •This claim is in the incorrect department, you must send it to the relevant department (mind you I don’t work at Gems nor do I know which department the claim must be submitted to.

Today I got the cream on the pie, the consultant said, I quote “I will not transfer to someone else nor my supervisor because I am telling you that this claim is in the wrong department and it is not my job to send it to the right department. Gems is a nonsense of a medical aid and I would NEVER advise anyone to sign up with they. They are of no help.

Their consultants are ***** and arrogant and they forget that they can also be in the same predicament. All this over payment for a 6 year old, meaning my child was suppose to die cause they were never prepared to pay for her procedure, mind you my premiums are always paid without fail or delay. At one point I was asked for a motivation of the motivational letter. How does one motivate a motivation.