LA
Lillian A
1 reviews | Active since Jan 2016
09 Nov 2021, 16:13
Easy to pay money but refusing to pay back
The gap cover rejected my first claim since I joined them in 2017/2018. I gave birth on the 05/03/2021 and before I was discharge we contacted the gap cover from the hospital as I thought they would pay the Co payment directly but I was informed that I must pay and then do a reimbur*****t claim but the consultant reassured me that she will take care of it. So after a few months I followed up as I never received the reimbur*****t money and there was no claim submitted appearantly??? I've resubmitted the claim and documents and now they told me it's over 6 months and they can't pay me back. I want my premiums back from the day joined up until today and rather move to a different gap cover.
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Stratum Benefits (Pty) Ltd's replyOfficial
10 Nov 2021, 10:07Hello Lillian Thank you for reaching out to us again. As mentioned previously on an earlier comment that we received from you on this platform, we explained that we need specific documents to assess claims. For co-payments, we always refund the client because it’s the client who would be asked by their medical aid to pay the co-payment upfront. We step in afterwards to pay you back, but in order to do that we need to receive the proper claims documents. Unfortunately, we never received the correct documents from you for the co-payment in question. We’ve checked our records, which we’ll happily share with you, where this was discussed on WhatsApp between yourself and one of our consultants. We’re sorry for any disappointment caused. Even now, we’d like nothing more than to accept your claim but it will be stale as it’s passed the 6-month period in which claims can be submitted. Best regards,
The Stratum Benefits Team
The Stratum Benefits Team
Stratum Benefits (Pty) Ltd's reply10 Nov 2021, 10:07
Official
Hello Lillian Thank you for reaching out to us again. As mentioned previously on an earlier comment that we received from you on this platform, we explained that we need specific documents to assess claims. For co-payments, we always refund the client because it’s the client who would be asked by their medical aid to pay the co-payment upfront. We step in afterwards to pay you back, but in order to do that we need to receive the proper claims documents. Unfortunately, we never received the correct documents from you for the co-payment in question. We’ve checked our records, which we’ll happily share with you, where this was discussed on WhatsApp between yourself and one of our consultants. We’re sorry for any disappointment caused. Even now, we’d like nothing more than to accept your claim but it will be stale as it’s passed the 6-month period in which claims can be submitted. Best regards,
The Stratum Benefits Team
The Stratum Benefits Team