1 reviews | Active since Oct 2013
WANT YOUR MONEY BUT WILL NOT GIVE IT BACK WHEN NECESSARY
<p>I am a govt old age pensioner and my daughter in law pays for me to have hospital pay out cover as I am not all that fit. I look after grandchildren etc to help her so this is the payment I get. I went into hospital on 5th Oct to 13th 10 days due to being very breathless despite my chest being clear. I had blood tests and was sent for a pulmonary embalism test which was fine, my chest x-rays showed clear. I then had a sonar and CAT scan due to liver blood results not being good and I have fatty liver disease. My breathlessness and shallow breathing got better without IV antibiotics. I was admitted for shortness of breath ? broncial pneumonia was ruled out which was a previous condition 11 months ago. Sunward Hospital put codes on the bill which include previous conditions and cronic conditions like diabetis, high blood pressure, arthritis, etc which you are not in hospital for but PMD says they will not pay out because of the codes on the bill. The codes on the bill are a requirement by Discovery Medical Aid .I got my GP who put me in hospital to write a letter explaining I was admitted for breathlessness and now have to get the hospital to change the codes. PMD make me, my doctor etc out to be *****. I submitted the claim rejected, objected to the rejection rejected again, went higher investgated how I would like to know rejected now have to go to the OMBUDSMAN. Really an old age pensioner with nothing and having to fight for what is right. This kind of treatment makes people think of committing *****.</p>
Hello FAIRYGODMOTHER,
We sincerely appreciate the concern you have expressed here.
As you are aware a member of our Client Representation Department has already be in contact with you to explain our position with regards to the outcome of your claim.
Whilst we are truly sorry to learn of your recent hospitalisation unfortunately your claim falls outside the ambit of your policy.
Assuring you of our continued best endeavours.
Kind Regards,
The PMD Team
Hello FAIRYGODMOTHER,
We sincerely appreciate the concern you have expressed here.
As you are aware a member of our Client Representation Department has already be in contact with you to explain our position with regards to the outcome of your claim.
Whilst we are truly sorry to learn of your recent hospitalisation unfortunately your claim falls outside the ambit of your policy.
Assuring you of our continued best endeavours.
Kind Regards,
The PMD Team
No -one has phoned me about this problem and I still think they are in the wrong and do not want to
pay out my claim. I have now obtained a letter from the specalist physician who agrees with my
GP that it is absolutely outrageous that PMD will not pay the claim. This will need to be escalated to the Ombudsman. It is so infuriating that I have to fight so for my money which is a legitimate claim.
No -one has phoned me about this problem and I still think they are in the wrong and do not want to
pay out my claim. I have now obtained a letter from the specalist physician who agrees with my
GP that it is absolutely outrageous that PMD will not pay the claim. This will need to be escalated to the Ombudsman. It is so infuriating that I have to fight so for my money which is a legitimate claim.