Liberty Medical Scheme
Unfair rejection of legitimate claim

My wife and I have been with Liberty Medical Scheme for over 7 years. We are extremely healthy and have never needed to make any claims. Last year my wife was pregnant and gave birth to a healthy baby boy. Our pediatrician did an in-hospital visit and filed the claim. We have a hospital plan so all hospital expenses are covered by our insurance with Liberty. About two months later we discover that the pediatrician's claim was rejected. We follow up to find out why it was not settled; the reason that Liberty gave for the rejected claim was that "the patient has no benefits", and the reason they came to this conclusion is because the claim was made in my wife's name, not in the baby's name. So the baby has benefits, but my wife doesn't, so they rejected the claim. This is the most ludicrous thing I have ever heard! The claim was for a PEDIATRICIAN'S visit, obviously it is for the baby! Never mind the fact the pediatrician informed us the Liberty had told them to always use the mother's name on the claim! The claim was filed again in the baby's name and AGAIN rejected for no good reason. We have now settled this bill ourselves and are in the process of leaving Liberty Medical Scheme.

Company: Liberty Medical Scheme
Country: South Africa
City: Cape Town

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