SM
Smangele M

1 reviews | Active since Aug 2013

07 Nov 2019, 15:53

Sanlam does not want to pay my claim

I sent my claims documents on the 27.08.2019 and seeing that Im not getting any feedback I tried calling few times and phone was just ringing.I sent a follow up mail on the 25.09.2019 still no feedback and turnaround time for Sanlam is 10 working days,I only received a call from a lady whom I forgot her name on the 27.09.2019,she apologised and promised to assist me if I resend the documents since they are unable to open the other documents I sent,I sent the documents the same day but still there was no movement on my case,I then sent a follow up mail on the 03.10.2019 still nothing up until I called on the 08.10.2019 I was then assisted by Richardo who checked and told me that Sanlam will not pay me since documents from the Dr and Bonitas dont correspond, I had to now do follow up with the Dr and Bonitas as to what happened,As I was busy trying to sort this problem I got a mail from Sanlam that they are done with the investigations and they wont pay anything since Bonitas covered everything, I was surprised because Dr charged me R8 500 of which Bonitas paid R3 699.58 and I paid R4 800.42 and their findings indicated that Bonitas paid R8 500,Bonitas statement shows the charged amount as R3 699 and paid the same whereas Drs statement shows all the amounts correctly.so I had to resend all the documents together with proof of payment to Sanlam. First of all had Sanlam attended to my claim as per their turnaround time this would have been picked up a long time ago and fixed,secondly I dont know how Medical aid and Dr do their statements so I cannot suffer because somebody captured incorrectly because I did my part by sending all the neccessary documents including proof of payment, so I feel that Sanlam does not want to pay because I even attached the receipt what more do they want.

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Replies (2)
Sanlam
Sanlam's reply07 Nov 2019, 16:02
Official
Dear  Smangele

We acknowledge receipt  of your complaint  and will investigate it.

Kind regards 
Sanlam  Client  Relations 
Sanlam
Sanlam's reply08 Nov 2019, 10:06
Official
Good morning, Smangele

We have been informed that the relevant department has made contact with you. We will be closing this matter on the Hello Peter platform, as your enquiry is now being dealt with by the relevant department.  Should there be any other issues relating to the matter, we once again encourage you to make direct contact with the relevant consultant.

We value you as a client. 

Kind regards, 
Client Relations