KM
Khatija M

1 reviews | Active since Mar 2009

18 Sept 2025, 16:17

*********** and totally unhelpful

Firstly consultant loaded the incorrect plan. I got the quote from the Opthalmologist that he is charging 400% over the scheme rate. I called to find out what I'm covered for because clearly I don't have that kind of money lying around and that's why I have gap cover only to be told they cannot assist till the procedure is done, then only can they assess the claim. What nonsense. I'm supposed to pay upfront approximately R90000, with no guarantee of getting any of it back. Why do I have gap cover then. Atleast medical is able to tell me how much they cover, why can't gap cover do the same. They never told me all this when they offered me the cover. All I want to know is to look at the quote and tell me what they cover, is that so difficult. If that's the case they must cancel my cover and give me back all my money because they falsely advertise their benefits. They expect me to do all the research, can't even assist with a written quote. All they can do is take my money and then look for any excuse to reject the claim

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Replies (1)
Zestlife
Zestlife's reply19 Sept 2025, 16:18
Official
Dear Khatija, 

Thank you for sharing your concerns. 
We sincerely regret the frustration and confusion you've experienced. Your concerns regarding the coverage process, communication around benefits, and the support you’ve received are completely understandable. Please be assured that we take your feedback seriously. While we do require certain information to process claims according to regulatory and policy requirements, we strive to make process clear and supportive from the start. 
We have reviewed your case in more detail and a member of the team will call you to assist you further to clarify your coverage and next steps. 
Thank you for bringing this to our attention, and we appreciate your patience while we work to resolve the matter. 
Kind regards, 
Noleen