Sanlam Gap Cover - incompetence, valid claims rejected

Lodged 2 claims that were rejected.

First one is for Opthalmology which the brochure reflects as covered. After several calls, I have struggled to get any feedback whatsover. No one bothers to call back and the team leader, Katelgo at Kaelo, has a sense of arrogance (I don't know any business that has an SLA of immediately. He tried only once to return a call, which I could not answer at the time, and not again.

Emails go unanswered and the turnaround time for each email is over 2 weeks!!!

Second claim was for dentistry. Nowhere in my policy document does it state that claims paid from medical savings are an exclusion! In any event, for out of hospital benefits, having an exclusion for claims paid from medical savings does not make sense. Generally, for out of hospital benefits, all claims are paid from medical savings! In any event, before the procedure, I called to ensure that the claim would be covered by the gap cover.

The level of service is utterly shocking. Sanlam needs to in-house the administration of the benefit as Kaelo is terribly useless. The contact centre's knowledge of the benefits offered is nothing short of shocking. They further do not log queries so that it can be tracked through time; so every time I call, it is as if we need to start the query from scratch, which is highly frustrating.

There is further no reference numbers provided!

Fix it - fast.