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Frans B
1 reviews | Active since Oct 2020
27 May 2021, 09:33
Genesis Medical Aid UNPROFESIONAL
Public/ South African citizens be very careful when joining Genesis Medical Aid- after a year and a half been a member paying my Monthly contributions with immediate effect my membership was terminated!!!! If you don't inform Genesis that you're Doctor has added a disprin to your chronic meds your membership will be terminated ask Frans Beket- please look for a legit Medical Aid
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Genesis Medical Scheme's replyOfficial
28 May 2021, 18:48Dear Mr Beket
Apologies for only responding to your complaint now. There was a technical issue on Hellopeter’s side causing their business portal and consumer site to hang.
To start with, we would like to inform you that all medical schemes in South Africa are indeed “legit”. A scheme’s rules are subject to the Medical Schemes Act and the industry is subject to strict regulatory requirements that are governed by the Council for Medical Schemes.
The matter is unfortunately not as simple as you put it. On the contrary, if it was just a Disprin at issue here, your membership would never have been terminated. “Disprins” are freely available over the counter. On the other hand, the use of prescription medication for several years for a medical condition that was not disclosed to the Scheme is a serious offense.
It is always very unfortunate when a medical scheme terminates a membership on the grounds of non-disclosure or material information. It is a matter that is taken very seriously and a decision that is made after careful consideration of all the facts.
The fact that all your current and previous medical information was not disclosed to Genesis was no fault of the Scheme. Understandably, the Trustees (and the Scheme rules) require that in instances like this, the necessary action be taken in order to be fair to the membership of the Scheme as a whole, particularly those members who fully declared details of pre-existing conditions when joining the Scheme and who were subject to the Scheme’s normal underwriting criteria.
The issue of medical non-disclosure is viewed so seriously by the Legislature that it provides for termination of membership and declared such behavior, when coupled with the submission of claims against a medical scheme, as a ******** offense.
Yours sincerely
GENESIS MEDICAL SCHEME
Genesis Medical Scheme's reply28 May 2021, 18:48
Official
Dear Mr Beket
Apologies for only responding to your complaint now. There was a technical issue on Hellopeter’s side causing their business portal and consumer site to hang.
To start with, we would like to inform you that all medical schemes in South Africa are indeed “legit”. A scheme’s rules are subject to the Medical Schemes Act and the industry is subject to strict regulatory requirements that are governed by the Council for Medical Schemes.
The matter is unfortunately not as simple as you put it. On the contrary, if it was just a Disprin at issue here, your membership would never have been terminated. “Disprins” are freely available over the counter. On the other hand, the use of prescription medication for several years for a medical condition that was not disclosed to the Scheme is a serious offense.
It is always very unfortunate when a medical scheme terminates a membership on the grounds of non-disclosure or material information. It is a matter that is taken very seriously and a decision that is made after careful consideration of all the facts.
The fact that all your current and previous medical information was not disclosed to Genesis was no fault of the Scheme. Understandably, the Trustees (and the Scheme rules) require that in instances like this, the necessary action be taken in order to be fair to the membership of the Scheme as a whole, particularly those members who fully declared details of pre-existing conditions when joining the Scheme and who were subject to the Scheme’s normal underwriting criteria.
The issue of medical non-disclosure is viewed so seriously by the Legislature that it provides for termination of membership and declared such behavior, when coupled with the submission of claims against a medical scheme, as a ******** offense.
Yours sincerely
GENESIS MEDICAL SCHEME