EK
Este K
1 reviews | Active since Oct 2013
07 Sept 2016, 09:44
Heavy disappointed
<p>I joined Medihelp knowing they are a good medical aid. I went to my Gynae for a routine check up and due to some problems he said he has to operate. Waiting on authorisation Medihelp said they needed to do an investigation to see if I didn't have a pre existing condition. My Dr send in the form saying I was treated and diagnosed with Endometriosis last year 2015.....and then medihelp said I did not disclose this in my application. I phoned my Dr and asked him why he said I have Endometriosis as I never once was diagnosed with Endometriosis ever. He acknowledged to me that he suspected that I have Endometriosis but did not disclose it to ME. I then wrote an email to Medihelp explaining this matter and asked them to asked the Dr as he said he will write a letter to them. I then just got a termination letter due to non-disclosure . I am very upset because how can I disclose something if I did not know I have it as the DR did not disclose it to me? Now I am penalized for someone else's mistake. I feel to take take this matter to the medical counsel. Do we as clients have no rights? Even if the mistake is made by the Dr and not yourself?</p>
Helpful (0)
Replies (3)0
Replies (3)
Medihelp's replyOfficial
07 Sept 2016, 10:17Dear esteevan
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Best regards,
Medihelp's reply07 Sept 2016, 10:17
Official
Dear esteevan
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Best regards,
EK
Este K's updateReviewer Update
12 Sept 2016, 09:16I am still waiting for an answer from Medihelp. Clearly they don't give a damn about clients. Looks like I have to escalate my complaint to the Registrars office, hopefully I will get answers then.
EK
Este K's update12 Sept 2016, 09:16
Reviewer Update
I am still waiting for an answer from Medihelp. Clearly they don't give a damn about clients. Looks like I have to escalate my complaint to the Registrars office, hopefully I will get answers then.
Medihelp's replyOfficial
13 Sept 2016, 08:38Dear esteevan
As explained during the telephonic conversation with a Medihelp consultant, you are within the first year of membership and it is Medihelp’s policy to investigate all benefit requests during the first year of membership for possible pre-existing conditions, to ensure that all information was declared on the application form.
Your case was referred to our Non-Disclosure Committee who, after considering all the relevant information, decided that you withheld information regarding your previous medical history and that your membership would be terminated.
I assure you that the Scheme is not indifferent to the needs or circumstances of its members. However, the Medical Schemes Act, 1998 places strict obligations on medical schemes to apply their rules consistently to all beneficiaries in order to promote and maintain effective and fair management as far as the granting of benefits is concerned. The Rules of Medihelp are binding on all members and no exceptions can be made, no matter how deserving a case may be.
Kind regards
Medihelp Customer Care
Best regards,
Medihelp's reply13 Sept 2016, 08:38
Official
Dear esteevan
As explained during the telephonic conversation with a Medihelp consultant, you are within the first year of membership and it is Medihelp’s policy to investigate all benefit requests during the first year of membership for possible pre-existing conditions, to ensure that all information was declared on the application form.
Your case was referred to our Non-Disclosure Committee who, after considering all the relevant information, decided that you withheld information regarding your previous medical history and that your membership would be terminated.
I assure you that the Scheme is not indifferent to the needs or circumstances of its members. However, the Medical Schemes Act, 1998 places strict obligations on medical schemes to apply their rules consistently to all beneficiaries in order to promote and maintain effective and fair management as far as the granting of benefits is concerned. The Rules of Medihelp are binding on all members and no exceptions can be made, no matter how deserving a case may be.
Kind regards
Medihelp Customer Care
Best regards,