Guardrisk
Blindly rejected my claim due to injury?

I am a principal member to AdMed Guardrisk under ADMEDADD policy (Policy Number: AP55878) and the claim ref is 4191128. There is a very clear clause in the section of waiting period - 1.1.2.2. arthroscopic procedures (except as a result of an accident/injury occuring after joining). That means there is an exception to the injury or accident that occurs in any month after the joining to Admed. I sustained an injury to my shoulder in September 2013, in whereas I initially joined to Admed in August 2013. That means this is an exception. That means you went against the policy and decided to not pay the claim. I now have lodged the complaint with the short term insurer. The doctor's motivation report is clear to what happened. It looks like there is a loophole in this clause. I will see what the short term ombudsman has to say about my rejected claim. Please be advised that I am hearing impaired.

Company: Guardrisk
Country: South Africa
City: South Africa

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