AG
Asherine G

1 reviews | Active since Apr 2021

19 Apr 2021, 10:17

Momentum - biased treatment & false advertising

I have been diagnosed with multiple critical illnesses which led to me being unemployed since Nov 2017. Seeing as I had myself covered through momentum for temporary income protector, critical/servere illness, dreaded disease, disability and life insurance I made the unfortunate assumption that Momentum would have my back financially. I was so wrong! I submitted a claim in October 2017 for my temporary income protector and the critical illness benefit. I was shunted around for 2 years. They kept declining my claim. I eventually got hold of the Ombudsman in 2018 and had to follow procedure which meant waiting. Eventually in Feb 2019 my claima where approved. My temporary income paid up all the arrear amounts and continued with payment until end Dec. Momentum as decided to pay out my disability claim instead of the critical illness claim and now I do not have any disability cover. I had a medical setback in the beginning of 2019 which led to 2 operations which led me to be incapacitated to work so in June 2020 I put in a critical illness claim. That's where the second nightmare began. I was subjected to such demeaning treatment. Momentum suddenly had a clause that started I had to be to be 50% or more impaired, AS PER THE AMERICAN MEDICAL ASSESSMENT GUIDELINE 6th edition (which was no where in my policy) they then proceeded to say that my ailments are not valid for a claim. They negated documents filled in by specialists doctors and my primary care management doctor saying that their calculations are incorrect. The doctor that works for Momentum basically trumps any other doctor/specialist and his findings are regarded as correct whereas my doctors and specialist where not. In other words Momentums doctor is. My experienced and qualified than all my specialists and doctors put together. The doctor assessed my condition without meeting with me once! How. Does that work? How you you diagnose and assess a patient you have not seen? Momentum isnt transparent. They do provide the services advertised on there website under each cover. I was never offered any help with my medical issues as promised. So now I am in a battle once again with Momentum - by the way they get to flaunt and bend the rules to suit them. They refer to old medicals yet tell me I have submitted old medical reports which cannot be used. How does that work? We are bound to make payments but can not use their benefits? As an individual am I supposed to drop dead and have a post-mortem done to prove I am sick? Will my death also be subjected to some other sort of rules, after Momentums doctor (who won't actually see me) makes his assessment based on Momentums requirements? Will they pay out upon my death or flaunt the "requirements" again to their benefit and reject paying out my life policy???

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Replies (2)
Momentum (SA)
Momentum (SA)'s reply19 Apr 2021, 11:11
Official
Good morning Asherine.
Thank you for bringing your complaint to our attention. We have escalated the matter to the service area and we will contact you during the course of today to assist.
Kind regards
Qhakazile
Momentum (SA)
Momentum (SA)'s reply19 Apr 2021, 13:25
Official
I received confirmation that the claims department has sent you an e-mail to resolve this matter.

Kind regards
Michele