Complimed
Refusal to pay shortfall on my medical aid account

I injured my back lifting a heavy object and sustained a slipped disc that pinched my sciatic nerve. I was in agony and after a week I lost feeling in my part of my leg [knee down to ankle] and lost strength and muscle loss of my thigh. My leg was getting thinner. I walked like this for about a year and a month and because I carry weights to callibrate scales it was auckward to to do the job with no strength in my leg. I took out the gap prod. for R200 a month. [there was a one year waiting period-fair enough] But 5/6 months into my gap I said to him I need to go for the operation. He said it would not be a problem provided I did not get treatment [I did not go for therapy or any treatment]. After the operation Discovery paid. The shortfall came to R11094, 30. I submitted the forms to Complimed. Got back e-mail saying "under investigation" Eventually I was told it was a pre-existing condition [something totaly diffirent to what I was told. Now remember I was told IF YOU DID NOT GET ANY TREATMENT YOU CAN HAVE IT DONE] and now they are not paying I blame S Calmeyer as he should have known better. So I paid the shortfall and he has the nerve to say I should reinstate this gap!!

Company: Complimed
Country: South Africa
City: Cape Town

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