SIRAGO - Extremely poor service

Dear Sir/Madam.

I have a GAP policy with Sirago, which has been ongoing for some years now. I pay my monthly premiums regularly every month (by debit order) but it seems that, when I have claims and need to call on them, they couldn’t care less.

During November and December of 2023, my wife was taken up into hospital in a very poor state of health and, after nearly a month in ICU, she finally died. Naturally there were huge medical expenses involved, most of which were covered by my medical aid, Bonitas, but there are several shortfalls, which have not been covered by them. For that reason I have had a Sirago GAP policy for many years to help in such times.

You will appreciate that, after my wife’s death, there were many things to attend to, not least of all her funeral. I am 79, so things go slower than they would have for younger people. I therefore waited for all the doctor’s accounts to come in before lodging my GAP claims with Sirago. On 12 February 2024, I finally lodged a claim with Sirago for the shortfalls in respect of six medical professionals. After two or three weeks I was contacted by email to obtain additional information from Bonitas, which I did, and submitted it to Sirago shortly thereafter. However, I received no feedback and, as their system is geared to make it all but impossible to make any direct contact with more senior staff (their helpline staff will give a name but NO contact details), I was left in the dark. Then, unfortunately, I also had a health setback and had to be admitted to hospital, where I lay for nigh on a month. When I was finally discharged in early April, there had still been no progress with my claims and I had no feedback from their staff as to what was causing the long delay. I emailed the claims department for feedback but again received a request for more information from Bonitas (after more than two months). I again obtained this information and passed it on to their staff. Shortly thereafter the smallest of the six claims was approved, but no word of the other five claims. I contacted the helpline and insisted that I be given the name and contact details of a senior person (hopefully a manager) in the claims department and all the operator would tell me is that the claims manager’s name is Althea Saunders but that he could not divulge her contact details; I would have to email claims and mark it for her attention. I have twice tried this but receive no response from her nor anything else to suggest what is delaying my claims.

In desperation I emailed the claims department with the CEO’s details, to be passed on to him, asking for him (Martin Rimmer) to please intervene or I would have no option but to report the matter to the ombudsman. It has now been ten days and no response – so probably they have not bothered to forward my mail to him and, as usual, his direct email address is well hidden. In the meantime, I am being pressed by doctors, pathologists and physiothe******s to pay them but am unable to settle their accounts out of my modest pension. It is now coming up for three months and I simply cannot escalate my complaint. The frustration is eating away at me and, as I have said, I am not young. I am deeply disappointed in Sirago as I feel this is shocking treatment by their staff and I feel absolutely helpless as they protect their senior staff so that escalation is impossible.

Yours faithfully

Alex Faria