NC
Nikki C
1 reviews | Active since Feb 2016
24 Jun 2021, 19:26
What is the point?
My claim has taken over a month to assess, just for them to obviously reject it. When I queried if I could claim for my co-payment made to the hospital, I was told there is no point as it will "probably" be rejected. I really appreciate the uncer*****y and negativeness towards getting reimbursed. I was also told my co-payment is not reflected on forms I have submitted - turn to page 2 of the hospital account.
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Stratum Benefits (Pty) Ltd's replyOfficial
25 Jun 2021, 11:15Hi Nikki,
We are sorry to hear that your claims journey with us thus far has been frustrating.
If you submit a claim with the correct documentation attached, as shown in our “Your Basic Guide To Submitting A Claim” https://bit.ly/3gSPglC, it should go fairly quickly. However, when a claim form is sent through and the correct documents are not attached for the claim to be assessed, unfortunately there are going to be delays.
The co-payment for which you are claiming is a general exclusion which is clearly stated in our brochure and is also stated in your policy schedule.
However, we are going to reach out to your broker to further assist and explain the benefit and process.
For clarity on the documents needed to claim and how to obtain these, or to give clarity on any benefits on your policy, we are always available to return a scheduled call, take a call or to answer a WhatsApp message, chat message or email.
We're always here to assist and are always very open and honest with our clients… even when it is not something they want to hear. This may not be the ideal answer you were looking for, but there are so many benefits to having Gap Cover so please don’t lose faith in us just yet.
Kind regards,
The Stratum Benefits Team
Stratum Benefits (Pty) Ltd's reply25 Jun 2021, 11:15
Official
Hi Nikki,
We are sorry to hear that your claims journey with us thus far has been frustrating.
If you submit a claim with the correct documentation attached, as shown in our “Your Basic Guide To Submitting A Claim” https://bit.ly/3gSPglC, it should go fairly quickly. However, when a claim form is sent through and the correct documents are not attached for the claim to be assessed, unfortunately there are going to be delays.
The co-payment for which you are claiming is a general exclusion which is clearly stated in our brochure and is also stated in your policy schedule.
However, we are going to reach out to your broker to further assist and explain the benefit and process.
For clarity on the documents needed to claim and how to obtain these, or to give clarity on any benefits on your policy, we are always available to return a scheduled call, take a call or to answer a WhatsApp message, chat message or email.
We're always here to assist and are always very open and honest with our clients… even when it is not something they want to hear. This may not be the ideal answer you were looking for, but there are so many benefits to having Gap Cover so please don’t lose faith in us just yet.
Kind regards,
The Stratum Benefits Team