Bad Client Service

Good day,

I am extremely disappointed with the outcome of my Old Mutual (OM)claim, considering the narrative below with regards to my claim.

My claim was submitted by my broker in mid-September 2021, our broker informed us that it will take 15 working days unless OM needs additional documents. In our case additional documents were required; however, it took the ENTIRE 15 working days to get feedback from claims department, and we submitted it as soon as possible. So, the 15 working days started again; however, this time, my broker was struggling to get hold of the assessor Theresa. On the 19th working day, he received feedback from her stating that they needed once again additional documents for the claim to proceed. My broker also enquired why she only rep**** on the 19th working day, her response was they do have a backlog; however, if we submitted the additional documents, the claim will be expedited.

THIS ALL TOOK PLACE BEFORE DECEMBER 2021, CONSIDERING OM ADVERSTISE PROUDLY ON YOUR WEBSITE CLAIMS HAVE AN 15 WORKING TURNAROUND.

My GP contracted Covid-19 and was in isolation and my broker, submitted the additional documents on the 29th of December 2021. Based on the conversation that Theresa had with my broker, we should have answer soon. However, it’s the 7th of January 2022 and 8 workings since the documents were submitted. We are still waiting on feedback from the Claims department.

My broker has called numerous times to the claims department but with no luck, just that the documents are being assessed. This is the lack of client service I received from OM. He tried to contact Grant, the team leader of Theresa, needless to find out that Grant’s on leave. He tried to contact another team leader, Jonathon Wessels, once again no answer from Johnathon’s side. I even tried the morning of the 7th of January 2022, AGAIN, hence by disappointed with OM’s client service.

On the 7th of January 2022, I lodge a complaint at the complaint department stating my grievances with regards to the service I am experiencing from OM. To my surprise, I received an e-mail from Michael Swart that he will escalate my query. (I felt that I have been heard). I had to follow up on the 12th of January 2022(3 working days since I lodge the complaint) by calling the client care number, there I was assisted by Derick @ 9:31 stating that he is unable to help him I must get hold of Michael by sending him an e-mail (POOR CLIENT SERVICE). I sent an e-mail to Michael on the 12th of January 2022, whereby he responded that on the 13th of January 2022, see the mail snippet below:

“Good day, Mrs Brooks Three of our claim assessors are off sick with Covid currently, hence the delay with assessing of claims. The senior assessor that I escalated your case to will be attending to your claim, and she promised feedback by no later than tomorrow. I will communicate as soon as I receive feedback from them”

On the 13th of January 2022, my broker received an e-mail from OM where they wanted “additional documents” which they had in their possession. Once again, I asked my gynecologist to provide them with the “outstanding documents” and my broker submitted the required document on the 31st of January 2022. He received confirmation for OM on the 1st of February 2022 that they received the documents and are attending this claim.

On the 4th of February 2022, OM requested documents that were ALREADY in their possession. My broker rep**** (on the 7th of February 2022) on their e-mail and attached mails, on when they received the documents and explained (documents-and dates that it was send to OM) it in his e-mail’s body.

On the 8th of February 2022, my broker followed up with OM again, and yet he was told that the claim was still being assessed. I phoned OM on the 10th of February 2022, enquiring about my claim whereby I raised my complaint about the service I received from OM and was told the claim is still being assessed. I even threaten to post on Hello Peter about the service I am receiving from them.

On the 12th of February 2022, my broker received an e-mail that OM would pay out the 1 claim, but not the other. Although my condition (endometriosis)is not considered a dread disease in my current policy, OM has updated their new policy to include it. However, under “activities of daily living scale” the boxes where ticked as I was unable to do most of the activities (snippet of my claim form below),hence I submitted the claim after engaging with my broker.

I feel that the decision of the other claim where subjective:

· Stating the fact that my broker and I phoned almost every day for feedback that OM could not provide.

· Me phoning OM and stated that someone is not doing their job.

· OM asking for documents that OM should have in my file. (Which they received)

· Me threatening OM with Hellopeter.

Before my operation, my husband and I were planning to start a family that will never materialise now, because of my current condition. The laparoscopy and draining of stomach cyst were done in February 2020, hoping that there might still be a chance for us to start a family. However, after the operation I was in severe pain throughout my recovery and consulted the doctor almost every week. I ended up in hospital again whereby they treated me with strong antibiotics and the doctor booked my off again. He also explained due my severe pain they need to do an open operation, (cut open from my belly button to below my bikini waistline) to remove my ovaries and drain another cyst again (My condition “chocolate endometriosis”) The open operation took place in June 2021. Just imagine putting your body through another operation again, while its still healing. Emotionally knowing that again I will be dependent on other people assist me with small things like getting out of bed, dressing me, assisting me with walking, turning me, bathing me, assisting when I need to use the toilet. My parents had to leave their home to come and look after me. During this ordeal, my husband had his cataracts removed from his left eye and I was unable to assist him due to being bed ridden. I was unable to take care of the family and unable to independently function because of the severe pain. It took a strain on my mental health; I am an independent woman and now to rely on others I felt belittled and helpless.