UNPAID CLAIMS - 2017

GEMS Medical Aid has been the most frustrating and inefficient medical aid scheme i have ever dealt with. I have been on 3 medical aid schemes prior to being part of GEMS and they are undoubtedly the worst ever!!!!! My claims that were put through last year in November 2017 have not been fully attended to despite being given 9 reference numbers. i have been constantly asked to call back to verify whether the claim is being attended to. Being a civil servant does not allow me sufficient time to follow up on the incompetency displayed by the claims department at GEMS. It is clear to see that service delivery appears to be non-existent at GEMS. It is rather frustrating to note that our queries regarding the claims will only be attended to upon our request and not as part of the normal procedure that is to expected tofollow through once a claim has been forwarded. i cant help but wonder if failure to process the claims effectively is a strategy on gems behalf who will automatically benefit on claims that are not being paid out. Is this action a deliberate ploy to save on budgets OR is a ploy on gems behalf to make life difficult for people lodging claims who out of frustration would just give up on following through with the claim.