ZS
Ziyanda S

1 reviews | Active since Aug 2021

28 Aug 2023, 11:59

Sanlam Living benefits (severe illness policy of R820 montly )for Top Proffesionals in a ***** to ***** from consumers

I have a top life cover for professionals with Sanlam Living and it has a standalone severe policy included and a retirement annuity. I was conviced by my broker who I have a relationship with since 2007 when I was still a Momentum Client. The products were so good and because of my long standing relationship with my broker over the years I thought why not join the Sanlam family. I submitted a claim as I was admitted to ICU and Sanlam has rejected the claim. I confirmed receiving their communication after 3 weeks . However, both my broker and I disagree that they are rejecting the claim solely on the basis of the myomectomy operation , as I also underwent five other procedures (laparoscopy, laparotomy, hysteroscopy, myomectomy, and bronchoscopy) during this illness, which resulted in a comatose state requiring mechanical ventilation for 94 hours between 15 May 2022 and 18 May 2023. I stayed in ICU up to the 27th of May 2023 when I was discharged. Consequently, Sanlam decision to deny the severe claim is biased and in conflict with the claws stipulated in the contract terms and conditions. Why do insurance companies always dont want to deliver on their promises to us consumers? Its disgusting and you should not in this profession since you dont leave up to your empty promises.

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Replies (6)
ZS
Ziyanda S's update28 Aug 2023, 12:03
Reviewer Update
In addition to the above rejection, there is also a wrist claim that is now 5weeks pending approval when their policy states it takes 10 working days to process and complete a claim. You are *****ing from the working class and when you must pay out, you have excuses. I plan to take my business elswhere as soon as all this is resolved and I have already informed my broker Justin Potgitier I want nothing to do with ******.
Sanlam
Sanlam's reply28 Aug 2023, 12:40
Official
Good day Ziyanda 
 
 We are sorry to hear of your poor client service experience. We have escalated your complaint to the relevant department. 
 
 Regards
 Sanlam Client Care
ZS
Ziyanda S's update28 Aug 2023, 13:43
Reviewer Update
From an intial claim that was sent on 19th July and the wrist one on 11th August you certainly have bad service when it comes to communicating with your clients, yet you never miss a single debit order!
Sanlam
Sanlam's reply30 Aug 2023, 11:43
Official
 Good day Ziyanda 
 
This is to confirm that you have been contacted and feedback was provided to you. 
 
Regards
 Sanlam Client Care
ZS
Ziyanda S's update07 Sept 2023, 11:18
Reviewer Update
Good day Sanlam

I am appualed by the fact that I had to come to this platform to get feedback and action from you. You could have done the contract validation before rejecting my claim. That is not acceptable considering that this policy is not cheap and its soppose to be a top tier cover for professionals. So I am having a difficult time convincing myself to continue having all my policies with Sanlam. The fact that you couldnt provide feedback within the 10 working days as stipulated in your contract was already questionable on your reputation to keeping your word to your customers. It would be intersting to see how this plays out in the end.
Sanlam
Sanlam's reply07 Sept 2023, 12:13
Official
Good day Ziyanda

We have relayed your message to the relevant department.
 
Regards
Sanlam Client Care