BJG
Barend J.C. Gouws

1 reviews | Active since Dec 2012

09 Dec 2022, 13:09

WARNING - Make sure you get pre-authorization even if you are in a comma.

WARNING They will NOT pay if you do not get pre-authorization, irrespective of the emergency! Heaven forbid you are in a serious accident where you are unconscious or are not in position to talk.

Speaking to the lady that declined my "pre-authorization" because I called on the way to the hospital (they had notes about that) but did not get pre-authorization before they could actually work on me. If you have been in an accident before, please tell me that you will sit there in pain and wait for authorization. The procedure will also NOT be covered that I must get now because the I did not get pre-authorization for the original incident.

I think their whole business model is build around the fact that in an emergency you are unable to call them or the family member that assists you does not know about the pre-authorization. I have NEVER had a claim that was pre-authorized and paid out, so I can not comment on if they actually do pay out in those cases, because a couple of years ago I also went into hospital for an emergency and after calling and getting the authorizations it turned out that I did not get it and they wanted to know whom I spoke to etc. (this was done standing at the counter of the ER calling Stratum. A couple of months ago when I went to casualties for something in my eye the ER called and got pre-authorization that was also not covered.

Truthfully reading through all these 5 star reviews it seems their admin and sales teams are excellent, whilst not paying out and dogging payments seems to be their specialty.

Make sure you take down names and dates and times.

I have just enrolled all the staff in my company, including taking myself over to the company benefits as well, which I am seriously considering cancelling after my last ordeal. On the previous occasions I felt that I could have done better, getting the pre-authorization and getting more information when I speak to them, BUT WHEN YOU ARE IN PAIN THINKING BECOMES LIMITED, you cant lay there whilst bleeding out waiting for authorization...

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Replies (1)
Stratum Benefits (Pty) Ltd
Stratum Benefits (Pty) Ltd's reply12 Dec 2022, 08:06
Official
Dear Barend,

Firstly, we would like to thank you for bringing your concerns and dissatisfaction to our attention.

We have asked our senior consultant to investigate the handling of your claim.  It is important that you are aware that we dont expect our members to call for a pre-authorisation while on comma, its unrealistic and is not part of our requirements.

You will receive feedback by close of business today.

Best regards
The Stratum Benefits Team