1 reviews | Active since Jul 2019
Gross Negligence in Handling of Outstanding Claim
I want to formally lodge a complaint regarding the completely unacceptable and negligent handling of my hospital claim, which remains unpaid despite an approved authorisation and months of persistent follow-ups.
I was admitted in September 2025 with a valid authorisation in place. To date, this claim has still not been settled with Lancet. I was explicitly informed at the end of December that payment had been made on 8 December 2025. This information was false. Lancet has confirmed that no such payment was ever received, and as a direct result of your failure, I have now been handed over for collection on an account that should have been settled months ago.
On 14 April 2026, the matter was escalated under reference number RFS 294463. Despite this, I have once again been told that the query is “still with the assessors,” with no accountability, no timeline, and no resolution. This response is both unacceptable and indicative of a complete breakdown in service.
This matter has been ongoing for over seven months. Throughout this time whilst I was a member, my premiums have been paid in full and on time, yet I am being subjected to ongoing delays, misinformation, and a complete lack of ownership from your side. Being repeatedly passed from one department to another without any clear answers is not only unprofessional but demonstrates a disregard for your members.
Your failure to resolve this matter has now caused me financial prejudice, reputational risk due to collections, and significant emotional distress. This level of service is inexcusable.
I require the following, without further delay:
1. Immediate written confirmation of the true status of this claim 2. Proof of payment (if payment was in fact processed, which is currently disputed) 3. Urgent settlement of the outstanding account with Lancet and confirmation thereof
Should this matter not be resolved as a matter of urgency, I will have no option but to escalate this complaint to the relevant regulatory bodies and pursue further action.
Thank you for submitting your query, and apologies for the inconvenience caused.
Thank you for the provided query reference number. We will escalate the query for urgent attention.
We appreciate your patience.
Your Choice for Quality Care
Sizwe Hosmed team
Thank you for submitting your query, and apologies for the inconvenience caused.
Thank you for the provided query reference number. We will escalate the query for urgent attention.
We appreciate your patience.
Your Choice for Quality Care
Sizwe Hosmed team
I was told my claim was approved for payment on the 18th May 2026 Reference number for the call is RFS324308 . I phoned today for a remittance advise and was told that the previous agent had made an error and that my invoice was not approved for payment. This a obviously a lie and I cannot believe that you have gotten to the point of actually lying about claims being paid and making me phone Lancet to update them and keep phoning you for a remittance for something that was never going to be done. This is honestly such a joke and a delaying tactic! I am now told the claim outstanding for Lancet from 29 September 2025 is now going to be submitted again for payment, I actually do not have any words and this is really such a joke. Cause it would seem no one actually know what is going on. Latest reference number for the call today where I was advise the claim was not actually paid is RFS 348357 . I have actually had enough and I am going to complain to the Ombudsman because I really do not know what else to do as I am pushed from pillar to post all the while I am handed over to attorneys for a claim where
I was told my claim was approved for payment on the 18th May 2026 Reference number for the call is RFS324308 . I phoned today for a remittance advise and was told that the previous agent had made an error and that my invoice was not approved for payment. This a obviously a lie and I cannot believe that you have gotten to the point of actually lying about claims being paid and making me phone Lancet to update them and keep phoning you for a remittance for something that was never going to be done. This is honestly such a joke and a delaying tactic! I am now told the claim outstanding for Lancet from 29 September 2025 is now going to be submitted again for payment, I actually do not have any words and this is really such a joke. Cause it would seem no one actually know what is going on. Latest reference number for the call today where I was advise the claim was not actually paid is RFS 348357 . I have actually had enough and I am going to complain to the Ombudsman because I really do not know what else to do as I am pushed from pillar to post all the while I am handed over to attorneys for a claim where