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sharlene R
1 reviews | Active since May 2016
04 Jul 2025, 17:05
********* - Total Risk Administrators – Misleading, Unprofessional, and *************
********* - Total Risk Administrators – Misleading, Unprofessional, and ************* I am utterly appalled by the service I’ve received from Total Risk Administrators (TRA) regarding my medical gap cover. What was initially presented as a safety net for medical shortfalls has turned into a complete nightmare. When I signed up, I was informed that only pre-existing conditions would be subject to a waiting period. However, I was blindsided to discover that routine and essential procedures like a colonoscopy and gastroscopy are also now being denied due to a so-called waiting period. This was never disclosed to me upfront—neither in writing nor during the onboarding call. It feels like TRA conveniently applies waiting periods only when it suits them, leaving clients stranded when they need support the most. To make matters worse: • The staff are poorly trained, dismissive, and lack even the most basic understanding of their own policies. • There is zero accountability or willingness to assist when you raise legitimate concerns. • The entire experience has been frustrating, time-wasting, and emotionally draining. TRA’s handling of this situation is not just unprofessional—it’s *********. I strongly advise anyone considering them to rather invest in a reputable provider like Discovery Health, where transparency and client care are actually prioritised. This is not just a complaint—it’s a warning. If you value your health and peace of mind, stay far away from Total Risk Administrators.
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Replies (3)
Total Risk Administrators's replyOfficial
04 Jul 2025, 17:22Good day Sharlene We're truly sorry to hear about your experience and appreciate that you took the time to reach out to our Customer Care team as well.
As explained during your call, your claim falls within the 10-month condition-specific waiting period, which is outlined in your policy documentation. This was also noted in your welcome email, where we encouraged all members to review their policy details, benefits, and terms to ensure clarity from the outset.
We understand that navigating medical claims can be stressful, especially during times of illness, and we never take it lightly when a member is unhappy with the outcome. Please rest assured that TRA remains committed to acting within the rules of the policy while always striving to treat our members fairly.
We do recognise the seriousness of your concerns and, to ensure that everything has been handled appropriately, your claim will now be escalated to our Complaints Department, which includes members of Senior Management. They will review all aspects of your case before making a final decision. TRA Management.
As explained during your call, your claim falls within the 10-month condition-specific waiting period, which is outlined in your policy documentation. This was also noted in your welcome email, where we encouraged all members to review their policy details, benefits, and terms to ensure clarity from the outset.
We understand that navigating medical claims can be stressful, especially during times of illness, and we never take it lightly when a member is unhappy with the outcome. Please rest assured that TRA remains committed to acting within the rules of the policy while always striving to treat our members fairly.
We do recognise the seriousness of your concerns and, to ensure that everything has been handled appropriately, your claim will now be escalated to our Complaints Department, which includes members of Senior Management. They will review all aspects of your case before making a final decision. TRA Management.
Total Risk Administrators's reply04 Jul 2025, 17:22
Official
Good day Sharlene We're truly sorry to hear about your experience and appreciate that you took the time to reach out to our Customer Care team as well.
As explained during your call, your claim falls within the 10-month condition-specific waiting period, which is outlined in your policy documentation. This was also noted in your welcome email, where we encouraged all members to review their policy details, benefits, and terms to ensure clarity from the outset.
We understand that navigating medical claims can be stressful, especially during times of illness, and we never take it lightly when a member is unhappy with the outcome. Please rest assured that TRA remains committed to acting within the rules of the policy while always striving to treat our members fairly.
We do recognise the seriousness of your concerns and, to ensure that everything has been handled appropriately, your claim will now be escalated to our Complaints Department, which includes members of Senior Management. They will review all aspects of your case before making a final decision. TRA Management.
As explained during your call, your claim falls within the 10-month condition-specific waiting period, which is outlined in your policy documentation. This was also noted in your welcome email, where we encouraged all members to review their policy details, benefits, and terms to ensure clarity from the outset.
We understand that navigating medical claims can be stressful, especially during times of illness, and we never take it lightly when a member is unhappy with the outcome. Please rest assured that TRA remains committed to acting within the rules of the policy while always striving to treat our members fairly.
We do recognise the seriousness of your concerns and, to ensure that everything has been handled appropriately, your claim will now be escalated to our Complaints Department, which includes members of Senior Management. They will review all aspects of your case before making a final decision. TRA Management.
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sharlene R's updateReviewer Update
04 Jul 2025, 17:30THIS IS A JOKE OF A COMPANY WITH COPY AND PASTE RESPONSES!!! NO PEOPLE ASPECT!!!
sR
sharlene R's update04 Jul 2025, 17:30
Reviewer Update
THIS IS A JOKE OF A COMPANY WITH COPY AND PASTE RESPONSES!!! NO PEOPLE ASPECT!!!
Total Risk Administrators's replyOfficial
04 Jul 2025, 18:31We would like to respond to the points you’ve raised.
Total Risk Administrators (TRA) is the administrator responsible for managing policies, processing claims, and supporting our members throughout their cover. However, the broker who sold you the policy has the primary responsibility to explain the terms, conditions, and waiting periods applicable to the policy you selected. These waiting periods are standard across the industry and are clearly detailed in the full policy document, which was emailed to you when your membership with TRA Gap Cover began.
Our welcome email also encouraged you to review your policy documents to confirm your personal details and become fami**** with the benefits, terms, and conditions — including the claims process. You were also welcome to contact either TRA or your broker should you have had any questions or concerns.
We are aware that you contacted our Customer Care team, and one of our trained agents took the time to explain the 10-month condition-specific waiting period to you. We have reviewed this interaction and can confirm that the agent remained professional and courteous throughout the call, and simply provided clarity on how the policy works.
We appreciate that medical claims can be emotional, especially during difficult health situations, but we must administer all claims in strict accordance with the policy wording, industry regulations, and our agreements with underwriters. Paying a claim that falls within a waiting period, without valid grounds, would place TRA at risk and would need to be explained to both our underwriters and auditors.
As previously mentioned in our response on Facebook, your complaint has been escalated to our Complaints Department, which includes members of Senior Management. They will review all available information and make a fair and informed decision based on the full context of your claim.
We remain committed to providing clear, honest service and to treating our members fairly and transparently. TRA Management
Total Risk Administrators (TRA) is the administrator responsible for managing policies, processing claims, and supporting our members throughout their cover. However, the broker who sold you the policy has the primary responsibility to explain the terms, conditions, and waiting periods applicable to the policy you selected. These waiting periods are standard across the industry and are clearly detailed in the full policy document, which was emailed to you when your membership with TRA Gap Cover began.
Our welcome email also encouraged you to review your policy documents to confirm your personal details and become fami**** with the benefits, terms, and conditions — including the claims process. You were also welcome to contact either TRA or your broker should you have had any questions or concerns.
We are aware that you contacted our Customer Care team, and one of our trained agents took the time to explain the 10-month condition-specific waiting period to you. We have reviewed this interaction and can confirm that the agent remained professional and courteous throughout the call, and simply provided clarity on how the policy works.
We appreciate that medical claims can be emotional, especially during difficult health situations, but we must administer all claims in strict accordance with the policy wording, industry regulations, and our agreements with underwriters. Paying a claim that falls within a waiting period, without valid grounds, would place TRA at risk and would need to be explained to both our underwriters and auditors.
As previously mentioned in our response on Facebook, your complaint has been escalated to our Complaints Department, which includes members of Senior Management. They will review all available information and make a fair and informed decision based on the full context of your claim.
We remain committed to providing clear, honest service and to treating our members fairly and transparently. TRA Management
Total Risk Administrators's reply04 Jul 2025, 18:31
Official
We would like to respond to the points you’ve raised.
Total Risk Administrators (TRA) is the administrator responsible for managing policies, processing claims, and supporting our members throughout their cover. However, the broker who sold you the policy has the primary responsibility to explain the terms, conditions, and waiting periods applicable to the policy you selected. These waiting periods are standard across the industry and are clearly detailed in the full policy document, which was emailed to you when your membership with TRA Gap Cover began.
Our welcome email also encouraged you to review your policy documents to confirm your personal details and become fami**** with the benefits, terms, and conditions — including the claims process. You were also welcome to contact either TRA or your broker should you have had any questions or concerns.
We are aware that you contacted our Customer Care team, and one of our trained agents took the time to explain the 10-month condition-specific waiting period to you. We have reviewed this interaction and can confirm that the agent remained professional and courteous throughout the call, and simply provided clarity on how the policy works.
We appreciate that medical claims can be emotional, especially during difficult health situations, but we must administer all claims in strict accordance with the policy wording, industry regulations, and our agreements with underwriters. Paying a claim that falls within a waiting period, without valid grounds, would place TRA at risk and would need to be explained to both our underwriters and auditors.
As previously mentioned in our response on Facebook, your complaint has been escalated to our Complaints Department, which includes members of Senior Management. They will review all available information and make a fair and informed decision based on the full context of your claim.
We remain committed to providing clear, honest service and to treating our members fairly and transparently. TRA Management
Total Risk Administrators (TRA) is the administrator responsible for managing policies, processing claims, and supporting our members throughout their cover. However, the broker who sold you the policy has the primary responsibility to explain the terms, conditions, and waiting periods applicable to the policy you selected. These waiting periods are standard across the industry and are clearly detailed in the full policy document, which was emailed to you when your membership with TRA Gap Cover began.
Our welcome email also encouraged you to review your policy documents to confirm your personal details and become fami**** with the benefits, terms, and conditions — including the claims process. You were also welcome to contact either TRA or your broker should you have had any questions or concerns.
We are aware that you contacted our Customer Care team, and one of our trained agents took the time to explain the 10-month condition-specific waiting period to you. We have reviewed this interaction and can confirm that the agent remained professional and courteous throughout the call, and simply provided clarity on how the policy works.
We appreciate that medical claims can be emotional, especially during difficult health situations, but we must administer all claims in strict accordance with the policy wording, industry regulations, and our agreements with underwriters. Paying a claim that falls within a waiting period, without valid grounds, would place TRA at risk and would need to be explained to both our underwriters and auditors.
As previously mentioned in our response on Facebook, your complaint has been escalated to our Complaints Department, which includes members of Senior Management. They will review all available information and make a fair and informed decision based on the full context of your claim.
We remain committed to providing clear, honest service and to treating our members fairly and transparently. TRA Management