Essential Med
Not paying out claim and no response to emails

I joined essential med on 1/9/2012. There is a 3 month waiting period therefore I can claim from 1/12/2012.
My wife was diagnosed with a hernia on 29/1/2013 by a specialist. The GP revered my wife to the specialist on 22/1/2013. My wife complained of stomach pain in 7/2012 but the GP diagnosed it as a Granoloma and prescribed pain pills. 22 January this year the pain got too much while menstruating and went to the GP. The GP revered her then to the Specialist. The Specialist Diagnosed the Hernia due to a c-section she had almost 6 years ago. The ICD 10 codes were sent with the relevant paperwork (also in my possession) to the Medical insurance so that my wife can be operated on to fix the hernia. The Insurance authorised the op according to the specialist and my wife organised the with all doctors and hospital and everything was organised to operate on Wednesday 6/02/2013.The Insurance phoned me Tuesday afternoon to tell me they were not going to pay any claims because, they say it is a pre-existing condition due to the pain she had on 7/2012 . To my knowledge a stomach pain is a symptom and not a diagnose. All the diagnoses were done in January this year relating to the hernia.

Company: Essential Med
Country: South Africa
City: Capetown

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