SD
Shirley D

1 reviews | Active since Mar 2020

29 Dec 2025, 09:51

Old Mutual Genrick Kaelo Dishonoring Claim

I submitted a claim with Old Mutual Genrik on the 03rd November. Their turnaround time is 7-14 working days. I was advised my claim was referred Medical Claim Assist. I have been waiting for feedback on the claim outcome since then calling every day-Old Mutual Kaelo. Initially i was advise that med assist would reach out my medical asking them to resubmit using PMB. On the 18 Dec i was included in an email communication indicating authorization was already processed using PMB and they referred to my November statement. On the 22nd i spoke to Kelly who was not willing to listen to what i was explaining i even asked to forward her the communication. What is concerning is everytime i would follow up on my claim i would be told about my claim. I have never took a policy it was not with medclaim and i was not advise that come claim state a blame would be shifted to third party. As of today we have exceeded the 14 days turnaround time give by Old mutual. On the 24th Dec i reach out once again on which i asked to spek to Portia because of the level of service i would get from Kelly was apoling she would rush me not willing to engage hence i asked for Portia. I was advised she would call back after she is finished with a call that was around 9. At 11 i called again and spoke to Nokthula who asked Portia to call me. When she called me at 11:45 she advised she only was advised that i called at 11. I narrated the whole thing to her she promised she would call before end business with feedback from medclaim. Again i am being told of medclaim. At 16:47 i called again and spoke to Liaam who advise claim is on final stage i should expect an sms. He indicated he could see claim it was back from medclaim and it was only submitted on date at 9. Liaam went as far as to confirm which claims that i was referring and which doctors. This morning i call once again spoke to kelly who said claim is still with medclaim. I called again spoke to Nardine who i ask her to transfer me to Portia. When i spoke to Portia she confirmed what Kelly had said. My concern is the conflicting information which i keep getting everytime i call. And also the fact i keep on being told about medclaim despite the turnaround time having already elapsed. Every call i keep on explaining i don't want to start new year with medical bills outstanding. i took this policy wanting peace of mind. This passing the blame to a third part which i am not contracted to is really irrating. I need feedback as a matter of urgency so i can see what further steps to take. I think Old mutual doesnot want to honor the contract.

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Replies (5)
Kaelo
Kaelo's reply02 Jan 2026, 08:43
Official
Good day Shirley, we completely understand your frustration in this matter and will ensure our team is informed to assist with great urgency. Apologies for the experience you have had. 
SD
Shirley D's update05 Jan 2026, 11:50
Reviewer Update
Dear Kaelo,

Please be advised, that i have not received any feedback to date.
Kaelo
Kaelo's reply05 Jan 2026, 18:47
Official
Good day Shirley, our team has informed us that they have been able to get in touch with you. Apologies for the inconvenience caused. 
SD
Shirley D's update07 Jan 2026, 10:53
Reviewer Update
On Monday i received a call from one of your specialists her name was Melissa. She seemed really clueless on the progress of my claim she kept on referring on documents that were received in November as she is awaiting documents to forward to the scheme. Documents the scheme has on their possession. The level of incompetence is truly staggering. She promised to keep me updated. Yesterday, i was advised she is on leave. I was advised another specialist is handling and i was promised i would receive a call from him urgently. Which is of now i have not received a call.
SD
Shirley D's update07 Jan 2026, 13:32
Reviewer Update
Strangely from yesterday i have been getting this communication.
Explain to me how this makes sense.
When all documents have been received and your turnaround time have already passed.
Devral has not called me from yesterday.


Claim in Process

Dear Valued Policyholder

We're getting closer!

Your claim documents have been checked and your claim has been moved to the next step in the claims process.

Our claims specialist is working on your claim. Please allow 7-14 working days for completion.

In the unlikely event that additional documentation is required we will reach out to you.

If you have any queries regarding your claim submission please contact us at *** or ***.

Sincerely,
The Old Mutual Gap Team


Dear Valued Policyholder

We're getting closer!

Your claim documents have been checked and your claim has been moved to the next step in the claims process.

Our claims specialist is working on your claim. Please allow 7-14 working days for completion.

In the unlikely event that additional documentation is required we will reach out to you.

If you have any queries regarding your claim submission please contact us at *** or ***.

Sincerely,
The Old Mutual Gap Team