POOR SERVICE FROM SIRAGO - VERY DISSAPOINTED

I am a cancer patient. The last thing I want to do is waste my energy and time following up with Sirago regarding my claims.

Sirago's payment policy "process and settle your claim within 10 working days "Unfortunately, this has not been the case. I emailed my claim on 26 July 2023.

This is the order of events to date: 26 July 2023 emailed my claim to Sirago. 10 August 2023 - I phoned Sirago to see why my claim has not been registered. I spoke to Gloria, who said she will forward my query to Delona the team leader.

14 August 2023 - I have received no feedback and had to phone Sirago again to see what is happening regarding my claim - I spoke to Sylvester who assured me Delona will call me back. Delona did phone me back on this day. She said she will forward my claim to the claims department for processing and follow up with me. I have had no feedback.

18 August 2023 - emailed Delona to follow up on my claim - no reply

21 August 2023 - I phoned Sirago to follow up on my claim, and spoke to Nathi. He advised me the claim accessor is busy with my claim as we speak. He will call me back with feedback. 21 August 2023 - Received an email from Sirago, minutes after speaking to Nathii, my claim is rejected!!! Rejection reason below:

25. POLICY SPECIFIC EXCLUSION You will have no benefit, and we will not compensate you for any illness, condition, disease, or injury, or the consequences of treatment of, or resulting from, or associated with:

The first 100% (one hundred percent) of the medical scheme tariff/rate (this will normally be covered by your medical scheme).

21 August 2023 - I called Sirago back again regarding the rejection, and spoke to Nathi. I had to explain how the Discovery remittance advice works, and that medical aid DID pay their portion on this claim. Sirago rejection is INVALID. Nathi to forward this information to the accessors and Delona. He will contact me today with feedback.

I want to mention that I have worked in the medical industry and with medical aids and accounts for 20 years. The level of service from Sirago at the moment is appalling.

They take no time whatsoever to investigate a more complicated claim. They reject claims incorrectly too easily.

I am looking forward to hearing from you Sirago