DS
Dhanz S
1 reviews | Active since Dec 2016
12 Oct 2020, 14:06
NO TO GENESIS MEDICAL AID
The rating of this medical aid scheme is not even worth a 1 star. They have no professionalism or ethics and we are always unable to get through to the contact centre, be it for admission or queries. N o efficiency at all!!! They have terminated my membership with an ingenuine and alleged statement of Non Disclosure of Material Information. Their staff are not equipped to even evaluate doctors reports before making such callous decisions.
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Replies (5)DS
Dhanz S's updateReviewer Update
12 Oct 2020, 14:16DO NOT!!! I repeat ...DO NOT ever make the mistake of joining this medical aid.....!!!! Rather deal with professionals and not amateurs in this field!!!
DS
Dhanz S's update12 Oct 2020, 14:16
Reviewer Update
DO NOT!!! I repeat ...DO NOT ever make the mistake of joining this medical aid.....!!!! Rather deal with professionals and not amateurs in this field!!!
Genesis Medical Scheme's replyOfficial
13 Oct 2020, 12:45Dear Dhanesheri
It is always very unfortunate when a medical scheme terminates a membership on the grounds of non-disclosure of material information. It is a matter that is taken very seriously and a decision that is made after careful consideration of all the facts.
In your instance, you consulted with a Medical Specialist just one week prior to completing your Genesis membership application form a few months ago (January 2020). At the time, you were diagnosed with a medical condition and treatment commenced.
Furthermore, your Specialist confirmed that you received treatment related to the same condition in 2012. None of this material information was disclosed to Genesis when you app**** for membership.
New members may think that it’s best to withhold certain medical information from their new scheme so that they could benefit immediately; however, all medical schemes have various risk management mechanisms in place to detect cases of possible or actual non-declaration.
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 Schemes’ normal underwriting criteria.
The issue of medical scheme non-disclosure is viewed so seriously by the Legislature that it provides for termination of membership and it declared such behavior, when coupled with the submission of claims against a medical scheme, as a ******** offense.
Not only is the act of non-disclosure of material information grossly unfair to the other members, but it leaves the providers, who treat these patients with the best intention, diligence and care, exposed when they are not paid.
Medical schemes cannot refuse an applicant’s application, or increase their monthly contributions for any previous or existing health condition that they may suffer from (or may have suffered from). The “worst” that may happen, is that they may receive certain waiting periods on certain conditions.
Honesty is always the best policy.
Yours sincerely
GENESIS MEDICAL SCHEME
Genesis Medical Scheme's reply13 Oct 2020, 12:45
Official
Dear Dhanesheri
It is always very unfortunate when a medical scheme terminates a membership on the grounds of non-disclosure of material information. It is a matter that is taken very seriously and a decision that is made after careful consideration of all the facts.
In your instance, you consulted with a Medical Specialist just one week prior to completing your Genesis membership application form a few months ago (January 2020). At the time, you were diagnosed with a medical condition and treatment commenced.
Furthermore, your Specialist confirmed that you received treatment related to the same condition in 2012. None of this material information was disclosed to Genesis when you app**** for membership.
New members may think that it’s best to withhold certain medical information from their new scheme so that they could benefit immediately; however, all medical schemes have various risk management mechanisms in place to detect cases of possible or actual non-declaration.
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 Schemes’ normal underwriting criteria.
The issue of medical scheme non-disclosure is viewed so seriously by the Legislature that it provides for termination of membership and it declared such behavior, when coupled with the submission of claims against a medical scheme, as a ******** offense.
Not only is the act of non-disclosure of material information grossly unfair to the other members, but it leaves the providers, who treat these patients with the best intention, diligence and care, exposed when they are not paid.
Medical schemes cannot refuse an applicant’s application, or increase their monthly contributions for any previous or existing health condition that they may suffer from (or may have suffered from). The “worst” that may happen, is that they may receive certain waiting periods on certain conditions.
Honesty is always the best policy.
Yours sincerely
GENESIS MEDICAL SCHEME
DS
Dhanz S's updateReviewer Update
13 Oct 2020, 13:20Your allegations had been responded to! Be advised that i was on a medical aid prior to even on Genesis. This is not a condition and inorder to establish that one would have to OBVIOUSLY be a medical professional. Imagine, the response to the letter had not even been considered is appalling. A laparoscopy had been done 8years ago, point 2 at the time of consultation with doctor in January it had not been discussed that a laparoscopy was an option and 3rdly how is it possible that Genesis never made mention to my appointment with doctor in August in which he then advised of a laparoscopy. The worst of it all when obtaining authorisation for this procedure it was tedious because no one answers at Genesis and the emails are only responded to when u are rude! The reviews on this medical aid speaks volumes on how Genesis operates. My daughter had been to the dentist prior to termination and 4 weeks later we have been notified Genesis hasnt paid, does this not show that a decision had already been made prior to my response!!!!! Up till date no further communication about when my monies will be paid. I have a patient, doctor relationship with Dr Ramsubag for 17yrs and Genesis has ruined this! I have made several referrals for this medical aid and now i have made sure that this experience reached all these families so that they can deal with professional and empathetic Medical Aid Scheme! Honesty is the best policy its best that you people at Genesis start with simpler values like integrity and reviewing your current system with the telephone lines and pre auth instead of having a monotonous and boring voice automated system and keeping using the excuse of covid to your'lls benefit. We are on level 1 and yes many people arr working from home but this place you never ever get through yet if i had to call me insurance for vehicles i able to do so even to individuals working at their home. I would not recommend this medical aid to anybody!!!!
DS
Dhanz S's update13 Oct 2020, 13:20
Reviewer Update
Your allegations had been responded to! Be advised that i was on a medical aid prior to even on Genesis. This is not a condition and inorder to establish that one would have to OBVIOUSLY be a medical professional. Imagine, the response to the letter had not even been considered is appalling. A laparoscopy had been done 8years ago, point 2 at the time of consultation with doctor in January it had not been discussed that a laparoscopy was an option and 3rdly how is it possible that Genesis never made mention to my appointment with doctor in August in which he then advised of a laparoscopy. The worst of it all when obtaining authorisation for this procedure it was tedious because no one answers at Genesis and the emails are only responded to when u are rude! The reviews on this medical aid speaks volumes on how Genesis operates. My daughter had been to the dentist prior to termination and 4 weeks later we have been notified Genesis hasnt paid, does this not show that a decision had already been made prior to my response!!!!! Up till date no further communication about when my monies will be paid. I have a patient, doctor relationship with Dr Ramsubag for 17yrs and Genesis has ruined this! I have made several referrals for this medical aid and now i have made sure that this experience reached all these families so that they can deal with professional and empathetic Medical Aid Scheme! Honesty is the best policy its best that you people at Genesis start with simpler values like integrity and reviewing your current system with the telephone lines and pre auth instead of having a monotonous and boring voice automated system and keeping using the excuse of covid to your'lls benefit. We are on level 1 and yes many people arr working from home but this place you never ever get through yet if i had to call me insurance for vehicles i able to do so even to individuals working at their home. I would not recommend this medical aid to anybody!!!!
Genesis Medical Scheme's replyOfficial
13 Oct 2020, 14:05Dear Dhanesheri
We do understand that you are upset, but the fact of the matter remains that you failed to disclose material information about your medical history when you joined the Scheme. The Scheme acted within its legal rights and in the protection of all its members.
You entered into a legally binding contract and you declared that you had read the rules, that you agreed to be bound by them and that your answers were true and correct in every respect. The only question is - did you disclose your medical history - yes or no? If you did, then when you were asked to confirm or deny the evidence available to the Scheme, you declined to answer. The public will be the judge.
Furthermore, you appear to blame Genesis for the national lockdown regulations…?
Slanderous comments will unfortunately not change the outcome.
We will no longer discuss the matter on this platform.
Yours sincerely
GENESIS MEDICAL SCHEME
Genesis Medical Scheme's reply13 Oct 2020, 14:05
Official
Dear Dhanesheri
We do understand that you are upset, but the fact of the matter remains that you failed to disclose material information about your medical history when you joined the Scheme. The Scheme acted within its legal rights and in the protection of all its members.
You entered into a legally binding contract and you declared that you had read the rules, that you agreed to be bound by them and that your answers were true and correct in every respect. The only question is - did you disclose your medical history - yes or no? If you did, then when you were asked to confirm or deny the evidence available to the Scheme, you declined to answer. The public will be the judge.
Furthermore, you appear to blame Genesis for the national lockdown regulations…?
Slanderous comments will unfortunately not change the outcome.
We will no longer discuss the matter on this platform.
Yours sincerely
GENESIS MEDICAL SCHEME
DS
Dhanz S's updateReviewer Update
13 Oct 2020, 14:46You people are pathetic and not professional at all! What is slanderous? That yourll fail to do a simple thing by answering the phones....see the other complaints and that is exactly what is being discussed!!! The monotonous answering machine doesnt help in away incase of an emergency! You absolutely right and on point and if i had read the reviews by the public i would have app**** to Genesis! What about claims prior to the procedure why was that not paid, it was not even for me it was for my daughter!!! What answer does Genesis have non disclosure that she still has milk teeth! More learned and educated individuals in the medical field would be of assistance in an organization like this!
DS
Dhanz S's update13 Oct 2020, 14:46
Reviewer Update
You people are pathetic and not professional at all! What is slanderous? That yourll fail to do a simple thing by answering the phones....see the other complaints and that is exactly what is being discussed!!! The monotonous answering machine doesnt help in away incase of an emergency! You absolutely right and on point and if i had read the reviews by the public i would have app**** to Genesis! What about claims prior to the procedure why was that not paid, it was not even for me it was for my daughter!!! What answer does Genesis have non disclosure that she still has milk teeth! More learned and educated individuals in the medical field would be of assistance in an organization like this!