TM
Tsakane M

1 reviews | Active since Nov 2019

12 Apr 2023, 12:05

Unacceptable service and delayed to NO resolutions

Firstly, the medical aid does not send through all claim statements, so when they reject claims due to benefits exceeded, you do not know how because they don't email you all your statements. Secondly, it takes them over 30 days to approve a claim, so if you continue consulting, there's a possibility your 4th claim might be paid before the 1st and the 1st claim never paid at all due to benefits exceeded. Thirdly, Day to Day savings are supposed to come through on the first of January every year but it's best to not consult in the January month because your claims will be rejected due to benefits exceeded whereas the year just started Lastly, They will pay from your day to day savings for benefits that have their own savings for example, Chiropractor benefits, dental benefits and optical benefits. Always check that they did not deduct from your day to day savings for these benefits

All the best, because the consultants never really know anything and they rely on the Team Leader foe everything and the Team Leader never responds or closes your enquiry without any resolution.

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply12 Apr 2023, 12:25
Official
Dear Tsakane, 

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