1 reviews | Active since Dec 2018
Horrible service from total risk gap cover
I took a gab cover with Total Risk about three years ago, I have been paying the subscription every month. Last year I was admitted for spine fusion operation. I received an sms from them saying that a claim from Dr........... has been assessed. A claim statement will be issued in due cause. Thereafter I did not received anything from them. According to them it was send to my e-mail. I did not received any correspondence from them because my mailbox was full. When I informed them that I did not received the e-mail they said I must send proof from my IT department that I did not received any e-mails. I did send them that proof and now someone called Naomi Buchner responded and said she need proof that my e-mail is full and the e-mails bounced back.
I have send them proof that I did not received any e-mails. At the moment it’s seems like they can take the subscription but will never pay for any claims. I am disappointed with the kind of treatment from them.
I feel like I have been ****med. I am unable to provide a policy number because I have never received any document from them except for the monthly debit order that have no reference.
Thank you for your review.
We apologise that this has been your experience. We will investigate your query thoroughly, at the highest level, and will reply as soon as we have all the facts in this case.
Best regards
TRA MANAGEMENT
Thank you for your review.
We apologise that this has been your experience. We will investigate your query thoroughly, at the highest level, and will reply as soon as we have all the facts in this case.
Best regards
TRA MANAGEMENT
In September and October 2019 your medical aid submitted claims to us with treatment date August 2019. On both instances we sent you an email requesting more information We also sent you 2 sms’ s informing you that your claims were processed (Kindly note the sms does not confirm that the claims are paid.)
On all 4 occasions we did not received a reply on our request and you never queried why the money was not paid into your bank account. As confirmed in our telephone conversation, claims are paid into the policyholder’s account unless otherwise informed by us.
The fist communication we received from you was in June 2020 (7 months after you returned to work). According to the rules in our Policy document all claims must be submitted with in 3 months from the date that the medical aid processes the claims. Unfortunately, your claims were 10 months old before you started querying payment.
The proof that we have requested that the emails bounced could not be confirmed by yourself or your IT Department.
Your request to review the stale claims was discussed in our Complaints Meeting. Based on the information we have, it is clear that the claims are now stale.
Unfortunately, we will not cover the outstanding claims as you did not adhere to the rules set out in your policy document.
Kind regards
TRA Management
In September and October 2019 your medical aid submitted claims to us with treatment date August 2019. On both instances we sent you an email requesting more information We also sent you 2 sms’ s informing you that your claims were processed (Kindly note the sms does not confirm that the claims are paid.)
On all 4 occasions we did not received a reply on our request and you never queried why the money was not paid into your bank account. As confirmed in our telephone conversation, claims are paid into the policyholder’s account unless otherwise informed by us.
The fist communication we received from you was in June 2020 (7 months after you returned to work). According to the rules in our Policy document all claims must be submitted with in 3 months from the date that the medical aid processes the claims. Unfortunately, your claims were 10 months old before you started querying payment.
The proof that we have requested that the emails bounced could not be confirmed by yourself or your IT Department.
Your request to review the stale claims was discussed in our Complaints Meeting. Based on the information we have, it is clear that the claims are now stale.
Unfortunately, we will not cover the outstanding claims as you did not adhere to the rules set out in your policy document.
Kind regards
TRA Management