During December 2011 we applied for the medical aid that was approved during January 2012 with the interception date of 01/02/2012. During this period my dependant fell pregnant, and when we tried to get the authorization for the delivery, we received a SMS that our medical aid is suspended. We submit a complain to Resolution Health, and they decided in favour of us, and withdrawal of the suspension, meanwhile the baby was born, and we had to pay for everything cash. When the suspension was lifted, we received the authorization and sent in the bills, but Resolution just sent an e-mail that they will pay us, but there it stops. The cost for the delivery was about R30 000-00, but only /- R5 000-00 was paid back to me. Resolution asked the silly question why the hospital didn't sent the claim to them, and we explained to them that the medical aid was suspended at that time and that we paid cash otherwise the hospital would not have done the delivery, meaning there was no claim from the hospital to Resolution. We have sent the proof that the hospital was paid cash, but Resolution still requests claim forms from the hospital. Resolution confirmed that they will do the payment.
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