MR
Merle R

1 reviews | Active since Nov 2017

08 Feb 2019, 16:00

Claim request not paid

My partner has been suffering from an autoimmune disease called - Polymyositis for a very long time. The first diagnosis by a Physician made about 10 years ago, however after being on various medications and not making proper progress,he really got frustrated not knowing which way to turn. During 2018 after watching a program on Disease Specialist,he managed to go see a Specialists and after several blood tests ,this specialist referred him to a Neurologist, again more blood tests performed. The Neurologist then confirmed that he definitely suffers from Polymyositis,his medication was changed. He was informed that it will take time for this medication to give him some relief,started on this new medication September 2018 and to this date he is still suffering, which nothing uncommon. To add to this medical condition, with the suffering he could not work anymore which meant he no longer earned income since last year, which lead him to submit claims under his PPS policies held. Needless to say what a painful process,the claims was submitted just over 7 months ago and to date PPS has yet to provide confirmation of a payout. In these 7 months numerous emails sent to them, they just kept on asking for more information, finally after they requested medical reports from the Physician he saw last in 2012 it appeared progress being made, not at all, they continued to drag their feet, not caring there is a person on the other end that has no income, but who continues to pay his monthly policy premiums from personal savings that has slowly been depleted,after all he has a life partner and a child in Matric to take care of. All that PPS are concerned about- non CARE, totally unprofessional, questioning a member integrity who has only been honest and transparent in the application. They have all relevant medical reports on record, including ones from the Disease Specialist and Neurologist, yet to date they still have not finalized a claim. Really pathetic, I will not recommend any professional to become a member of this type of organization

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Replies (4)
PPS
PPS's reply08 Feb 2019, 16:23
Official
Good day Merle

Thank you for taking the time to share your concerns with us. We will investigate your claim and provide feedback within the next two business days. 

Regards
Naeema Cole 

Best regards,

MR
Merle R's update08 Feb 2019, 18:39
Reviewer Update
Dear Naeema Thank you for your reply. Just a correction, i meant to state the first visit to the Physician took place 2012 and the 1 st diagnosis of the condition was confirmed in 2014. Kind regards Merle
PPS
PPS's reply11 Feb 2019, 08:21
Official
Good day Merle

Thank you for your feedback. We will be in contact with you shortly regarding the claim.

Regards
Naeema Cole

Best regards,

PPS
PPS's reply21 Feb 2019, 12:47
Official
Good day Merle

I trust our PPS Claims department has been in contact with you and provided you with feedback on your husband's claim.

I'm glad we could assist you in the process of resolving this query.

Kind regards
Maalika Karjieker

Best regards,