I am very dissapointed in Medscheme. I always thought I had a great medical aid scheme until I started claiming more regularly this year due to an operation and pregnancy. As it turns out this scheme is very effective in collecting premiums, but horrific at paying out claims.
I had an eye operation done on 28 March and submitted the claim on 10 April. The operation was finally pre-authorised a few days beforehand, after they first tried to get out of it by declining authorisation twice. I also submitted another (smaller) claim on 10 April which was paid out within 10 days as usual. I am still waiting for the bigger payout. I have phoned four times (just got reference numbers) and emailed (zero response).
When I phoned again today (13 May), the excuse was that they could not open an attachment and therefore not process the claim. I checked my sent items and everything was fine. The three different call centre agents I spoke to previously also never mentioned this issue.
It is clear that this agancy attempts not to pay for (even authorised) claims or to delay payments for as long as possible. If I was not forced to be with them (through my job) I would not be.
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