STRATUM BENEFITS : THE ART OF PREVARICATION

In March 2024 I made my first claim against Stratum Benefits [pty] Ltd. As medical claims go this was for a modest four figure sum, in fact less that 5 months of premiums. I rendered all the invoices from each of the parties involved. I received an automated response acknowledging receipt of the claim and supporting documentation. Then nothing happened for some 2 months, where upon I contacted Stratum again to determine what progress had been made. I was told the claim could not be processed as my documentation was not acceptable and that they required the medical aids actual disbur*****t statements. I then forwarded each of Medshields statements that reflected each disbur*****t. Another month passed without any response. Then I phoned and spoke to someone who promised to look into it. Still nothing happened. I then phoned again, this time taking note of who I was speaking to. M/s Govender appeared very conciliatory and promised to look into and respond, which she did. She came back saying that Stratum Benefits required a reconciled statement from Medshield setting out all claims and payments. I contacted Medshield who said that this was not conventional, but they would see what could be done. As good as their word Medshield responded in a few days with a comprehensive account, which I then sent to M/s Govender, which she emailed acknowledgement of, and saying all the documentation was now in order, undertaking that someone would respond to me within 5 - 7 days. That same afternoon she wrote to the broker who had established the policy [copying me ] saying that the Medshield reconciled account was unacceptable as they had submitted this on a Nexus accounting printout. Nexus is one of the largest accounting systems used in the world, and I, and I suspect no other members are in a position to dictate to their medical aid company what accounting software they may use. Two days later another clerk, not M/s Govender emailed enclosing the format of the account that they required from Medshield. Would you believe that what they were requesting was the same as the original Medshield emails they had been copied with originally! This company must win the all time award for avoiding paying out!