JP
Jomar P
1 reviews | Active since Feb 2020
30 Nov 2020, 15:01
Pathetic Claims Department
I would appreciate it if competent staff will be appointed to handle claims submissions. The online submission only allows 1 statement per section to be uploaded. I have than sent a separate email with all the relevant documents attached needed for the claim submitted. Now I receive feedback that the gap cover does not pay rejected amounts which I know is part of the policy reason being why I submitted the second medical aid statement where the rejected amount was paid at medical aid rate. I am sick and tired of having to deal with *********** people and wasting my airtime & data which is not reimbursed. Management please deal with these staff members or arranged retraining for these people.
Would appreciate it if my claim can be processed to pay the Docter.
Helpful (0)
Replies (4)0
Replies (4)
Total Risk Administrators's replyOfficial
30 Nov 2020, 16:34Good Day Jomar. Thank you for your review. We will investigate your claims experience and be in contact as soon as possible. Regards. TRA Management.
Total Risk Administrators's reply30 Nov 2020, 16:34
Official
Good Day Jomar. Thank you for your review. We will investigate your claims experience and be in contact as soon as possible. Regards. TRA Management.
Total Risk Administrators's replyOfficial
30 Nov 2020, 17:48Dear Mrs Plaatjies. We do apologise for the inconvenience caused. Unfortunately one agent was only working on online submissions and the other agents on claims submitted via email. Due to this process, the response was different as the agents could not see both emails from you. Thank you for bringing this to our attention. We will investigate the online process and discuss streamlining it with our website developers. We always value and appreciate the input from our Policy Holders. You are welcome to contact me directly should you require my assistance. Kind regards Naomi
Total Risk Administrators's reply30 Nov 2020, 17:48
Official
Dear Mrs Plaatjies. We do apologise for the inconvenience caused. Unfortunately one agent was only working on online submissions and the other agents on claims submitted via email. Due to this process, the response was different as the agents could not see both emails from you. Thank you for bringing this to our attention. We will investigate the online process and discuss streamlining it with our website developers. We always value and appreciate the input from our Policy Holders. You are welcome to contact me directly should you require my assistance. Kind regards Naomi
JP
Jomar P's updateReviewer Update
02 Dec 2020, 01:22I am officially taking this matter to the medical complaint review board to fight to have your licence revoked for *********** members. I am paying my membership on time every month but now I need to fight to get my shortfalls paid but this is the reason for having gap cover. TRA now decides how the medical aids should cover while the medical aids have their own scheme rules. You people are *********** members and adding more stress to members health than anything else and mind you that I do not claim for the inconvenience caused as well. Stop being pathetic and selling off excellent benefits and once you’ve received members funds always looking for excuses to pay.
JP
Jomar P's update02 Dec 2020, 01:22
Reviewer Update
I am officially taking this matter to the medical complaint review board to fight to have your licence revoked for *********** members. I am paying my membership on time every month but now I need to fight to get my shortfalls paid but this is the reason for having gap cover. TRA now decides how the medical aids should cover while the medical aids have their own scheme rules. You people are *********** members and adding more stress to members health than anything else and mind you that I do not claim for the inconvenience caused as well. Stop being pathetic and selling off excellent benefits and once you’ve received members funds always looking for excuses to pay.
JP
Jomar P's updateReviewer Update
02 Dec 2020, 09:30Thank you Naomi Buchner. With such an amazing person like you on the Management team TRA will reach great success. Keep up the excellent customer service you are brilliant and most kind at what you do.
JP
Jomar P's update02 Dec 2020, 09:30
Reviewer Update
Thank you Naomi Buchner. With such an amazing person like you on the Management team TRA will reach great success. Keep up the excellent customer service you are brilliant and most kind at what you do.