Claim Avoiding Techniques
1. Benefit Claim Form - Certificate of Medical Attendant to be completed from the records of Midrand Health Emporium regarding your medical history for a 3 - 5 year period prior to 14.4.2016 (including copies of all reports and test results on file).
2. From your treating medical specialist, we require copies of all reports and test results on file in support of the claim.
There are too many documents that are required that are beyond my reach. I don't even stay in Midrand anymore. I don't think its fair for me to spend a lot of time trying to find this kind of information that's beyond my reach. If you want medical reports, on the claim form there are contact details for my specialist and Old Mutual has the concert to access my medical records. It's all a technique to make me quit the claim. Send an email directly to the specialist with my concert to access medical records and request the information. No 2 yes I can do it but number 1 no.
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Replies (2)
Old Mutual's replyOfficial
14 Mar 2018, 15:41Dear Simiso
Thank you for the review.
We apologise for the inconvenience caused in this regard. We will investigate and contact you directly to resolve.
Regards
Brent Sellidon
Complaints Management
Best regards,
Old Mutual's reply14 Mar 2018, 15:41
Official
Dear Simiso
Thank you for the review.
We apologise for the inconvenience caused in this regard. We will investigate and contact you directly to resolve.
Regards
Brent Sellidon
Complaints Management
Best regards,
Old Mutual's replyOfficial
15 Mar 2018, 08:57Dear Simiso
Thank you for your review.
Please note that it the claimants responsibility to prove that a claimable event has occurred and that the insurer should pay.
In terms of requirement number one. On the application form you stated that your usual doctor is Midrand Health Emporium, we have tried to confirm this per telephone without success. Please confirm this so that we may write to them directly or this requirement.
I have also sent you an e-mail in this regard.
Regards
Brent Sellidon
Old Mutual Complaints Management
Best regards,
Old Mutual's reply15 Mar 2018, 08:57
Official
Dear Simiso
Thank you for your review.
Please note that it the claimants responsibility to prove that a claimable event has occurred and that the insurer should pay.
In terms of requirement number one. On the application form you stated that your usual doctor is Midrand Health Emporium, we have tried to confirm this per telephone without success. Please confirm this so that we may write to them directly or this requirement.
I have also sent you an e-mail in this regard.
Regards
Brent Sellidon
Old Mutual Complaints Management
Best regards,