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Ian S

1 reviews | Active since Jan 2018

10 Sept 2023, 21:46

SizweHosmed is not even worth 1 star.

This is the worst medical aid company.Trust me when I tell you this.My mom of 73 was hospitalised in March and April 2023.Still waiting on them to settle the accounts.Infact I am still waiting for them to settle her July/Aug 2022 accounts.A staffmember of SizweHosmed by the name of Loyiso contacted me approx 7 weeks ago when I first complained via Hello Peter,but the accounts have still only been partially paid.I believe SizweHosmed are deliberately delaying the Claims process.This is the honest truth-Just read all the other reviews,and it will give you a clear indication of what is happening there.They either do not pay the Claims, or they partially pay the claims.They also tend to pay the doctors from your "Day to Day Benefits" pool instead of the "Inhospital" pool when you are hospitalised.When you get hospitalised over a weekend/public holiday,it then becomes a nightmare to get an Auth number from them especially after having received emergency attention from the doctors the weekend.(So please don't get admitted to hospital over a weekend because then you will have to fight with Sizwe to get the Auth number and to get them to pay the hospital bill).And here is their favourite tactic of not paying....They apparently will not look to pay your claims if you have not enquired about why they have not paid the bills within 60 days.The thing is.... many doctors will only inform you after 60 days that they were not paid by Sizwe.And secondly,how are members over the age of 60 and 70 able to establish if their bills were correctly paid by Sizwe within 60 days,if Sizwe themselves can't even settle a straight forward claim or handle a simple enquiry within 7 working days. SizweHosmed is a real disappointment.I am going to take this further with the medical scheme council and tribunal if the bills are not paid,as I have all the proof to take this to the very top.This nonsense seriously needs to stop!!!

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply11 Sept 2023, 07:53
Official
 Dear  Ian,

Thank you for submitting the query, we sincerely apologise for the inconvenience caused. 
We will be in contact with you to resolve your complaint. 

Sizwe Hosmed team