MM
Mufhati M

1 reviews | Active since Feb 2023

27 Apr 2023, 21:16

Declining claims and Intentional delay of authorization

I joined medshield with a preexisting medical condition. When I app**** for preauthorisation it was declined and my membership was canceled because i had allegedly not disclosed my preexisting condition. I tried calling them to inform them that I had disclosed, but they said they would investigate, but the investigation was never done and my membership remained terminated. I approached the company which I had used to join medahield and after they intervened my membership was reinstated. I was informed by the company, but I am the one who had to constantly call medshield medshield to confirm the reinstatement with medshield, and my records with them showed that my membership was terminated and the people I spoke to could not assist. After multiple calls the problem was resolved and I was reinstated, but my preauthorisation application is being delayed even though I was told that it would be authorized. I never received a call or email to apologize, and to this day I have to constantly call them to follow-up. It's like they are looking for a reason to decline again. It is very stressful that they treat me like I don't pay my premiums. My application has been with their assessment team for over 6 months now.

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Replies (1)
Medshield
Medshield's reply25 May 2023, 18:27
Official
Good day,

Medshield Medical Scheme would like to thank you for bringing your concerns to our attention.

Kindly be advised that your complaint has been reviewed and a response has been forwarded to your email address registered with the Scheme.

Yours sincerely,Medshield