Zestlife

Zestlife Gap Cover was recommended to me and based on the recommendation I took out Gap cover. I recently under went a knee replacement but based on my medical aid I was asked to pay a co-payment before surgery could proceed. I duly made the payment believing my gap cover would reimburse the co payment. Since lodging my claim with Zestlife for my shortfalls on the procedure I have had nothing but delay after delay. My pre-authorisation for surgery given my the medical aid stated I was required to make the co-payment. The hospital account show my payment & Zestlife were sent a copy of my payment but still this wasn't sufficient. The surgeon who did my surgery belongs to a network called Improved Clinic Pathway services, where all my surgery accounts were forwarded to them & the network made the claim to the medical aid & the medical aid in turn paid them who paid the necessary doctors. My statement from my medical aid show the payment to the network but because it does not show my co payment on my statement from the medical aid they are disputing my claim. It seems like one excuse after another. When one has had a major surgery the last thing you feel like doing is having to continually fight for something you understood would be a matter of course when taking out gap cover. Every phone call to Zestlife is something different is required, no one phone call gives you all the information. Whilst they list what needs to be submitted they do not deal with circumstances that aren't quite as straight forward as when your doctor belongs to a network. Feel very frustrated that business in South Africa where it means paying back the client is always a delay or full of excuses. My advise to people do your due diligence before signing up for any service, Ask the right questions because there are always hidden clauses.