AE
Ashraf E

1 reviews | Active since Apr 2009

23 Apr 2026, 14:19

Claim not captured or processed

Once again, I submitted a claim for refund for a specialist consultation registered on a care plan for a PMB condition on 9 April 2026. The claim has not even been captured, let alone refunded. The only explanation "there's a backlog". Since Sizwe Hosmed takes ages to refund or pay claims, I am out of pocket for the amount claimed with absolutely no idea if I will even get my money back next month if it is not captured and processed before the monthly payment run! How is this fair? I pay my contributions every month on time and always end up fighting for benefits which seem to be diminishing more and more. Very disappointed..

0
Replies (4)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply23 Apr 2026, 14:25
Official
Dear Ashraf, 

Thank you for submitting your query, and apologies for the inconvenience caused. 
Kindly provide the query reference numbers. We will escalate the query for urgent attention. 

We appreciate your patience. 

Your Choice for Quality Care
 Sizwe Hosmed team 
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply23 Apr 2026, 14:53
Official
Received with thanks, Ashraf. 
AE
Ashraf E's update29 Apr 2026, 22:28
Reviewer Update
My claim is still not captured or processed yet another week later.
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply05 May 2026, 11:46
Official
Kindly note that we have followed up on the claim. 
We will provide feedback as soon as it is available. 

Sizwe Hosmed team