Bonitas
Bonitas won't pay for emergency

On 29/12/2013 I was rushed to hospital with what I suspected was a heart attack (chest pains, palpitations, dizzy, short of breath, numbness, blurry vision etc). After reporting to reception and handing over my Bonitas card (I have a hospital plan for emergencies) I was taken in, examined and put on an ECG and had blood taken. After nearly 4 hours there, I was stable and the doctor said it was more than likely a stress related attack and that my heart is possibly under strain but I was in no immediate danger of dying. A few days later I got a Bonitas SMS saying they've paid R6.52 for my hospital visit. I thought this was strange but a few days later I got my bill, the rest of it which wasn't covered. I took it up with my broker and Bonitas who after the first call told me that they have no record of my ordeal (the hospital told me they cleared things on my arrival) then after getting the hospital involved, eventually told me that YES, it is considered an emergency but NO they won't pay because the ICD code doesn't link to a PMB. Since then I also received the pathology account which was declined by Bonitas too. For what I pay monthly, I expect such an emergency to be covered.

Company: Bonitas
Country: South Africa
City: Cape Town

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