Unjust decline of medical support

Dear Sir/Madam,

I am writing to formally lodge a complaint regarding the withdrawal of a previously approved pre-authorization for medical admission.

On 7 April 2025, GEMS granted a pre-authorization for Mr. Thulani Mkrola (ID Number: ***) to be admitted to Elim Clinic for rehabilitation for alcohol abuse and addiction. Based on this pre-authorization, Mr. Mkrola was duly admitted and began receiving treatment, including detoxification and continued the****utic support as part of an integrated recovery program.

However, on 10 April 2025, a letter was issued by GEMS rescinding the authorization. This reversal has severely disrupted Mr. Mkrola’s treatment programme. At the time of withdrawal, Mr. Mkrola had already commenced his rehabilitation and was receiving critical therapy and support as per the clinic's structured programme with accumulated fees to an amount of approximately R12000.00

This abrupt decision not only compromised the continuity and integrity of his care but also poses significant health and psychological risks, potentially reversing the progress made during the initial phase of treatment.

I respectfully request that GEMS urgently review this decision and reinstate the authorization to allow Mr. Mkrola to continue and complete his rehabilitation at Elim Clinic without further disruption. I also ask that the reinstated authorization be communicated directly to Elim Clinic to avoid further administrative delays.

I trust that GEMS will act with the urgency and empathy required in this matter. I am willing to provide any additional documentation or clarification needed to facilitate a swift resolution.

Thank you for your attention to this matter. I look forward to your positive response.

NB I am aware that HOSPITAL EVENTS MANAGEMENT is awaiting underwriting feedback, but this matter is urgent and important, hence it needs prompt resolution. Sincerely, Thulani Mkrola *** *** (On behalf of Thulani Mkrola – ID: ***) Membership number ***