BC
Brett C
1 reviews | Active since Feb 2013
18 Apr 2025, 23:33
Disappointed
Had to make a claim after 9 months so I was still in the waiting period but I claimed because it was for a recent condition subsequent to my taking out the policy. Stratum however insisted it was pre-existing. I've decided to cut my loses and cancel the policy. Maybe they're fine once you've been with them after 12 months (I can understand that they don't want to pay out to newly signed up clients) but after this experience I don't want to risk it.
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Replies (2)0
Replies (2)
Stratum Benefits (Pty) Ltd's replyOfficial
22 Apr 2025, 09:52Good day Mr. Cooper,
Thank you for raising your concerns regarding your Gap Cover Claim.
The matter has been escalated to our Claims Manager.
We will send an email with final feedback soon.
Have a good day.
Kind regards,
The Stratum Benefits Team
Thank you for raising your concerns regarding your Gap Cover Claim.
The matter has been escalated to our Claims Manager.
We will send an email with final feedback soon.
Have a good day.
Kind regards,
The Stratum Benefits Team
Stratum Benefits (Pty) Ltd's reply22 Apr 2025, 09:52
Official
Good day Mr. Cooper,
Thank you for raising your concerns regarding your Gap Cover Claim.
The matter has been escalated to our Claims Manager.
We will send an email with final feedback soon.
Have a good day.
Kind regards,
The Stratum Benefits Team
Thank you for raising your concerns regarding your Gap Cover Claim.
The matter has been escalated to our Claims Manager.
We will send an email with final feedback soon.
Have a good day.
Kind regards,
The Stratum Benefits Team
Stratum Benefits (Pty) Ltd's replyOfficial
22 Apr 2025, 11:07Dear Mr. Cooper, Kindly note that all cases flagged as a possible pre-existing condition are referred for thorough investigation, which is conducted directly with your service provider. Based on the information provided to Stratum by your service provider, the claim has been assessed and subsequently deemed to relate to a pre-existing condition. For clarity, as confirmed by Andrea at Dr. Nel’s rooms, the first consultation relating to the procedure performed on 11/03/2025 took place on 18/06/2024 — which was prior to the inception of your policy. In view of the above, the claim was rejected accordingly based on a pre-existing condition. Please note that a pre-existing condition is defined as any diagnosis, treatment, medical advice, test, procedure, or surgery that occurred in the 12 months prior to the start date of your policy. Should you require any further information or clarity, please do not hesitate to contact us. Should you have any further questions, please feel free to contact us. Regards, The Stratum Benefits Team
Stratum Benefits (Pty) Ltd's reply22 Apr 2025, 11:07
Official
Dear Mr. Cooper, Kindly note that all cases flagged as a possible pre-existing condition are referred for thorough investigation, which is conducted directly with your service provider. Based on the information provided to Stratum by your service provider, the claim has been assessed and subsequently deemed to relate to a pre-existing condition. For clarity, as confirmed by Andrea at Dr. Nel’s rooms, the first consultation relating to the procedure performed on 11/03/2025 took place on 18/06/2024 — which was prior to the inception of your policy. In view of the above, the claim was rejected accordingly based on a pre-existing condition. Please note that a pre-existing condition is defined as any diagnosis, treatment, medical advice, test, procedure, or surgery that occurred in the 12 months prior to the start date of your policy. Should you require any further information or clarity, please do not hesitate to contact us. Should you have any further questions, please feel free to contact us. Regards, The Stratum Benefits Team