From Bad to Worse: Is Polmed Still a Medical Aid or Just a Claims Rejection Machine?

I never imagined that getting basic medical care for my child would turn into a battle with my own medical aid — twice in one year.

My daughter recently injured her ankle at school. She was in severe pain and could not walk properly. As any concerned parent would do, I immediately took her to our GP. After examining her, the doctor referred us for a radiology ultrasound to ensure there was no internal damage or fracture in her ankle.

It was a standard, medically necessary referral.

To my shock — Polmed rejected the claim.

This is now the second time within one year that Polmed has rejected claims for treatment I am supposed to be covered for. As a paying member, I am left confused and frustrated. What exactly am I covered for? Emergency care? Specialist referrals? Basic diagnostic imaging?

Medical aid is meant to provide peace of mind during stressful times. Instead, I am faced with uncer*****y, administrative stress, and unexpected financial pressure — all while trying to care for my injured child.

I do not understand what is happening within Polmed’s management, but if legitimate claims continue to be rejected at this rate, their client base will inevitably decline. Members cannot continue paying high monthly contributions only to fight for basic healthcare benefits.

I am now in a position where I need advice and assistance.

How can these rejections be challenged effectively?

What rights do members have in situations like this?

Who oversees medical aid schemes to ensure fairness and accountability?

I urge Polmed to review its claims process and provide transparency to its members. Trust, once lost, is difficult to rebuild.

At this point, I am not angry — I am deeply disappointed.