GL
Graham L

1 reviews | Active since Nov 2023

08 Nov 2023, 09:03

Pathetic service from Sanlam Gap cover!!!

I am at my wits end with Sanlam Gap! I registered a claim on the 13th of September 2023, I sent all the documents that was requested and the claims process is supposed to take 7 to 14 working days but to date the claim has not been finalized! I had a few doctors on the claim and only received a payments for 2 doctors. I keep calling in and telling the consultants what needs to be done as the claims assessor working on my claim is ***********. I even spoke to the manager Lamese Alexander a few times but nothing has been finalized. After a lot of back and fourth they informed me that everything will finally be finalized on the 23rd of October but on claims remittance they again left out 4 doctors, after I went into detail and wasted my breath and airtime countless times explaining to the consultants what needs to be done. When I called in I was told that they finalized the claim and after speaking to the consultant Sam on the 23rd, she advised that she will reopen the claim and explain to the claims assessor what they missed and what still needs to be done, I was told it will take 3 to 5 working days for them to finalize after the claim was reopened again. On the 6th business day "Tuesday the 31st of October" I called in again and was told that the claim still isn't finalized, I asked to speak to a manager and spoke to Lamese again, she advised that she will speak to the assessor and call me back in an hour which never happened. On the 1st of November I called in again and spoke to Lamese, she advised that the claims assessor was supposed to finalize the claim the day before so she will find out what's happening. On Friday the 3rd of November I called in again, as I received a email that they will refer the claim to a 3rd party, I spoke to Lamese and she advised that she will call us back will feedback as the claim is finalized and awaiting authorization but to date we still have not received a call or email that the claim is finalized. We need urgent assistance with our claim as the service we received from Sanlam Gap cover is pathetic. There is no urgency and the administrator "Kaelo" is not client centric, honestly Sanlam needs to reconsider another administrator as they give Sanlam a bad name.

0
Replies (5)
Sanlam
Sanlam's reply08 Nov 2023, 09:08
Official
Good day Graham  
 
 We are sorry to hear of your poor client service experience. We have escalated your complaint to Sanlam Gapcover. 
 
 Regards
 Sanlam Client Care 
Sanlam
Sanlam's reply08 Nov 2023, 13:09
Official
Good afternoon Graham

We have received feedback from Sanlam Gapcover that they have been in touch with you and that they are busy assisting you.

Regards
Sanlam Client Care
GL
Graham L's update08 Nov 2023, 15:32
Reviewer Update
Good afternoon,

I was contacted by the complaints department and the claim was "finalized" but the claims assessor got it wrong once again! All the claims department needs to do is give me a call so we can go through it together to avoid this back and fourth and any confusion they may have. I sent so much documents since the 17th of September, so clearly they looking at the wrong thing or they just don't know what they doing. At this point I'm irate that they got it wrong again and yet again they missed another doctors payment, this is honestly pathetic!
Sanlam
Sanlam's reply08 Nov 2023, 15:34
Official
Good afternoon Graham

We are sorry to hear this and have arranged for you to be contacted by the responsible department.

Regards
Sanlam Client Care
Sanlam
Sanlam's reply08 Nov 2023, 16:31
Official
Hello Graham

We have received feedback that you have been contacted and assisted.

Regards
Sanlam Client Care