Tone deaf underwriter and ******** complaints team

To whom it may concern.

My emails dated 11, 14 and 15 August, wherein the complaints team was copied in with no response bear reference.

I called in twice and was advised that the complaints team has not bothered to acknowledge my email or provide a response as I did not send the email directly to you. I was also informed by a lady named Khethiwe that Ntsako from complaints had spoken to Tobias the underwriter who advised that my financial advisor (Queen) would be in touch to discuss the underwriting progress. I did not get a call or any email from Ntsako and had to call back on Friday, only to be told by Melo that complaints had a discussion with Tobias who told them that he is not aware of the second form that was submitted, which is a blatant lie, if he did not receive the second form, where does the confusion that Queen refers to in her email to me stem from? You can’t be confused if you only have sight of one form. I would hope that truth/honesty speaks to one of the ethical values of PPS as I have been dealing with an underwriter who is tone deaf and if your call centre people are not lying, is also a **** running with a narrative that is not true.

As a complaints team, you have not bothered to follow your own process

On Friday, I received an email from Tobias (mind you, he did not bother to reply to my emails sent in the past week). In his email, he still makes reference to a depression diagnosis that does not exist.

For Context:

In June, I reached out to Queen to inform her that I was changing jobs and have decided its best to keep my benefits at PPS. I noted my intent to return to PPS and get a sickness benefit cover and life cover. Queen expedited the process of quotes, and medicals with the nurse that was sent to my place twice; as someone who works quite closely with underwriting I completely understood why the second set of medicals was required. I then got a call from Queen on a Tuesday evening noting that I had been excluded for anxiety, to which I rep**** on the phone “that is understandable”. I proceeded to sign the document that she asked me to sign. At the time of receiving the call, I was still at work and could not go through the document thoroughly, which in hindsight I should have done, to ensure that what I was being told over the phone matched with the details on the policy doc. I finally found time to go through the document and that is when I realized that a list of mental health exclusions had been added.

I reached out to Queen and requested to chat to the underwriter to understand why I was being excluded for a bunch of conditions I have never claimed for under the mental health umbrella. A meeting was scheduled and I unfortunately could not make it as I was pulled into a work meeting. I made an effort to get hold of Tobias telephonically and explained the following to him:

My anxiety and panic attack diagnosis was circumstantial and caused by the work environment that I was in at the time.

I changed jobs and its been 2 years with no incidence as the anxiety was environment specific.

In his email, he noted that PPS may review the decision to lift the exclusion 2 years from now if I remain symptom free. I then noted that if we use his metric, then it has been 2 years with no relapse. He noted that a medical questionnaire can be sent to my doctor and then the underwriting decision will be reviewed upon receipt of the report/questionnaire.

I sent an email to the last email address I had on record for the Dr’s offices requesting that they complete the form, when I got no response, I called the practice and was advised of a new email address. I sent the email again to the correct email address and followed-up until we received the forms.

When the form came in on 06 August, I rep**** on 07 August with the following email, you will note that Tobias and Queen are in the email, therefore, your underwrite is WELL AWARE that there will be another report incoming:

I then received an email from Tobias on Sunday the 10th noting that he had discussed the form sent and my diagnosis of DEPRESSION!!!!! Why did he proceed to discuss when he was in copy in the email that I sent back to the doctor and had the amended report sent to him on the Friday????

I would like us to apply ourselves here. If I was lying, why would I challenge an entire Dr who has my file at her disposal and note that the diagnosis of depression is incorrect? I intentionally copied Tobias in as I knew that Queen will send him the first form we received. I didn’t copy him in for vibes, I was hoping he would apply logic.

The form was received on 08 August and I made reference in the email body to both Queen and Tobias to take note of the new form

I sent an email to Tobias on Monday (which he chose not to respond too). Queen attempted to call me and I chose to ignore the call because at this point, I would like for all my dealings with both Queen and Tobias to have a paper trail.

Queen sent me the following email in response to the email I sent on Monday

I requested clarity on where the confusion stems from and attached both reports that the doctor had completed. I received no further response from Queen, your complaints team or the underwriter. Just silence on PPS’ end.

This has been quite draining for me. At this point I was hoping we would have completed this process and have premiums going off.

I could just let your underwriter get away with being tone deaf with my case, I could just let him lie and say he does not have the amended questionnaire when it was clearly sent to him, I could also just turn a blind eye to the email he sent on Friday that still mentions a diagnosis of depression when he is in an email that clearly refutes the diagnosis; but this is bordering on becoming ********* and I would like to believe that PPS takes pride in being ethical in their dealings.

How is a complaints department taking the word of an underwriter lying about not having the second form and then closing it off without contacting me? I had to resend the form and evidence of Tobias being copied in to Melo on Friday. The feedback that complaints has spoken to Tobias was provided to me by Khethiwe and Melo when I called in.

These are real people that you deal with on a daily basis. Real lives with real implications with the work that you do. I have asked for this to be escalated beyond Tobias and was ignored.

And so PPS Complaints team, I write directly to you in the hopes that you will care enough to follow process. I will also have my complaint on hello peter and other social media until this is resolved.

Once again, I am refusing to be underwritten with exclusions. My fight here is the manner in which this has been handled by PPS and the subtle bullying to accept a diagnosis that does not exist in my medical file.

I am hoping we will come to a close on this matter in the coming week as this has unnecessarily taken up my time.

Regards Pam

PS: Images attached in email sent to PPS complaints team have been removed for POPIA reasons