My brick wall communicates better than Sizwe

If I could give zero stars I would.

My wife is currently expecting and as everyone knows, or ought to know, there is a lot of medical expenses that go along with it. We signed up for medical aid, because kids were always on the table, and we didn't want the stress and inconvenience of dealing with hospital and doctors bills on top of dealing with pregnancy and a newborn. Boy were we mistaken!

There are many inconsistencies that surface when dealing with Sizwe, of which the main issue is their utter shocking communication and how each customer service advisor contradicts the other. Two instances I would like to highlight are:

1. Sizwe's Bambino Programme states that member's are covered for 2 major scans (12 week down's scan, and the 20 week Facial Deformity scan). Nowhere in the T's and C's does it state that these scans have to be done by a OBGYN or a GP, I was told this after we had done the 12 week scan through a Fetal Sonographer as referred to by our OBGYN, as they do not do them anymore (I had phoned and asked OBGYN's from all over the Eastern Cape all the way to George in the Western Cape). When the bill returned as unpaid by our medical aid I gave Sizwe a call to ask why the scan was rejected and was informed of the information above. When I mentioned that there are no OBGYN's in our area that do these scans, it can only be done by a fetal sonographer, I was given the answer of "you should let your doctor register you as a high risk pregnancy, then you will have additional benefits", on another call I was told that "you should get authorization that scans be done by a radiographer", "We can not authorize that as it falls under another benefit", "can't you ask your doctor to do the scan", and my favorite "This has been resolved". We ended up having to pay the full bill personally, and we still have not gotten a concrete answer as to why these weren't covered under the bambino programme considering there is no alternative to fetal sonographers doing these scans. I have placed upwards of 10 calls surrounding this 1 matter and have gotten 10 different answers.

2. As per Sizwe's mail receipt response, matters will be dealt with and communicated back within 3-5 business days. Now I understand that 3-5 business days is a lie companies tell people to make them feel important and valued, but you can not tell me that we have to wait 3-5 weeks to get an automated response that "The matter had been resolved and the case is now closed" when we have received no information on it at all. We had to have blood tests done through ampath and it was submitted to the medical aid. There are 2 different tests that use the same item code and it was returned "unpaid" and the reason was that it was submitted as a duplicate. We have emailed Sizwe's claims department with all the necessary documentation proving that it was for 2 different tests multiple times, and the only response we got was "the claim was sent for payment" and "this matter has been resolved and closed", just to get a claim form where the bill remained unpaid.

Sizwe has not been an issue in our house until the pregnancy came around, and their customer service has been utterly disgusting and appalling ever since. I would only recommend Sizwe if the question is "Which Medical Scheme should I avoid". See, Sizwe? Clear cut answer, and I can promise you it will be consistent.