I made the unfortunate mistake of moving from a medical aid to One Plan. The first time I had to claim, they rejected the claim because my husband got i'll 2 days before our waiting period was over, so they considered his operation (pre existing condition). So the second round I have a claim again. I phone in to check that all the docters etc was paid, and pick up that one was not paid. But the friendly consultant tells me I must just get the invoice again and submit it. I do that the next day. Then they reject this invoice, and say because it's out of the 3 months window period. I dispute this, and they refer me to their supervisor, who promises to pull the call recording and come back to me. I am still waiting it's been almost 2 months now. So I phone today 21 Feb 2013, and this supervisor is on sick leave, and they can find any notes on the system to see or even confirm that the recording was ever asked. Then I try to speak to a manager, and they tell me there is no manager until that supervisor comes back on Tuesday next week. Also how do you reject a claim for 17 days, when whole desember everyone is on leave and closed??? That not fair!!!
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