No payment for claims

Unpaid claims. I am very unhappy with Medihelp.

My wife is on a network option whereby Medi Clinic is not a part of. My wife had a threatening miscarriage during her pregnancy. At the time the doctors, in Kroonstad, were we stay, could not help us and Kroonstad has no Gynaecologists. We were reffered to a Gynaecologist in Welkom as it was the closest town with a gynaecologist and this was an emergency situation. When we arrived the Gynae told us that we were just in time, had we been a bit later we would have lost the baby.

After my wife was discharged I was surprised to receive a statement whereby there’s a co-payment that needs to be paid. I immediatly disputed it as this case was marked as a pmb. Medihelp has a policy if the situation is life threatening then it pays full medical fees of the hospital if the hospital does not fall part of network hospitals.

Two weeks after my wife was discharged she again had a relapse whereas we again rushed her to the hospital. When we arrived the hospital refused to take her in unless we pay the co-payment for the previous visit. I had no choice and made the payment to have her admitted.

Till now I have had no joy and Medihelp still refuses to refund me even though all the doctors reports have confirmed that this was a life threatening situation.

Mariska had since given birth to our baby. She gave birth at a midwife whereas Medihelp approved the claim for the mid wife’s fee. It had been 3 weeks since and still no payment has been made.

I am utterly disgusted with their poor service!