YA
Yaseen A

1 reviews | Active since Dec 2013

08 Apr 2024, 13:07

Poor claims Service

I would like for optivest to put the same effort when selling insurance as to when there is a valid claim. On the 27 march 2024 I submitted a gap cover claim to optivest with all required documents only got feedback on the 4 April 2024 now a Anja Wandrag as informed that on page 6 policy wording (fine print) they need "supply in writing any such proof, medical evidence, or other information as the Company may reasonably request" The proof is the hospital and medical aid statement and the receipt were i had to pay the short fall. This is gap/short fall is to cover me for what my medical aid falls short to pay My personal medical report is private. So here we need to be reserved about being ****med into taking these gap covers as clearly here when a claim arises there part has alot of red tape to pay out I wouldn't have went into hospital for no reason and spent 4.5 days there And now being a client with optivest for over 10 years I have issues like this were there is no regular claim history for a response like this Unacceptable Optivest I expected more for a insurer.

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Replies (3)
Optivest
Optivest's reply08 Apr 2024, 14:08
Official
Dear Yaseen,

Thank you for your recent review submitted through Hello Peter.

Thank you for bringing your concerns to our attention. After reviewing your feedback, we understand that the issues you raised pertain to the rules governing your Gap Cover, which is managed by a separate entity.

While Optivest does not establish the specific documentation requirements, typically such documents are necessary for a thorough clinical evaluation by the insurer.

Please note, we have forwarded your concerns to the Gap Risk Administrators for their attention, to either assist you or the further clarify the matter. 

Best regards,
Optivest Health Services
YA
Yaseen A's update08 Apr 2024, 17:48
Reviewer Update
Thank you for the reply
Seems like this is a deflection not to take on any responsibility as optivest is the broker and now I'm left to deal with gaprisk while You as the broker sits back and collects on the monthly commission and broker administration fee while I sorting this out now.
Will take it a normal business practice by optivest and will make sure to update the all social platforms with the service standards and deflection of responsibilities
Thank you
Optivest
Optivest's reply12 Apr 2024, 09:06
Official
Dear Yaseen,

We can confirm that Gap Risk has contacted you with regards the reason for the reports and hope the call clarified your query.

Kind Regards
Optivest Health Services