1 reviews | Active since Oct 2015
Misrepresentation NO Oncology cover will be paid
Oncology gap cover really
As far as my knowledge when you an oncology patient 99% of your expenses is chemo medication and doctor visits. When I was diagnosed with cancer I phoned in to confirm that my oncology claims will be paid. It was explained to me that the 20% copayment that the medical aid will charge when I run out of funds will be paid 100%.
Medication that I claimed for was chemo drugs. Well according to Zestlife this is medication and they do not pay medication. The policy does not say that chemo drugs is seen as medication. Why do you still have an oncology benefit on this policy if you do not pay? Please remove oncology benefit from your policy as you do not pay oncology gap cover.
I have contacted Sirago as I am not going to go on with a GAP policy where Zestlife misrepresented themselves.
Dear client,
Zestlife GAP covers an oncology co-payment that you have to pay once you reached your medical aid limit and this benefit is limited to a maximum of the 20% of the invoiced amount.
This is clearly stated in the policy and was explained to you when you enquired about the product.
The GAP benefit that was paid to you was 20% of the invoiced amount. I regret if your expectation was that the full shortfall would be covered, however we can only pay benefits in terms of the policy wording as this is what the premiums are based on.
Kind regards
Noleen
Dear client,
Zestlife GAP covers an oncology co-payment that you have to pay once you reached your medical aid limit and this benefit is limited to a maximum of the 20% of the invoiced amount.
This is clearly stated in the policy and was explained to you when you enquired about the product.
The GAP benefit that was paid to you was 20% of the invoiced amount. I regret if your expectation was that the full shortfall would be covered, however we can only pay benefits in terms of the policy wording as this is what the premiums are based on.
Kind regards
Noleen