TC
Taylor C
Active since Jun 2019
31
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31 reviews10 months ago
Formal Complaint Follow-Up – Lack of Acknowledgement and Action | Policy NYP3749440
Dear Dotsure Team, I am writing to formally complain about the handling of my policy (NYP3749440) and the denial of my claim (NYP3749440-00004) for an accident on May 21, 2025. I believe your decision to decline the claim and void my policy is unjustified, and your management of this matter has been inconsistent and unprofessional, causing me significant distress. While I do not contest the cancellation enacted on June 4, 2025, effective May 31, 2025, citing alleged misrepresentation, I strongly disagree with this allegation and have lost all confidence in Dotsure as my insurer. I object to your decision to deduct the R6,649.00 paid for a valid home contents claim from the total premiums collected, as this unfairly penalizes me by offsetting a legitimate claim against unrelated vehicle premiums. Below, I outline my position and demand a fair refund calculation. Grounds for Complaint 1. Unjustified Claim Denial and Policy Voidance Your letter dated June 4, 2025, states that my claim was declined because you “reasonably concluded that [I] misrepresented/failed to disclose in full the insurance history linked to [me], [my] wife, and [my] property,” leading you to void the policy from inception under the “Dishonesty” clause. I strongly contest this conclusion. When I app**** for the policy on December 12, 2024, I was asked if I had ever had a policy cancelled, to which I truthfully answered “no.” The previous policy, cancelled last year due to excessive claims, was in my wife’s name—not mine. Furthermore, after inception, I provided tracker certificates for our vehicles (2013 Audi A6 and 2015 Ford Ranger), including full VIN and engine numbers. With these details, you could have cross-referenced your records to identify any prior policies linked to these vehicles. I acted in good faith and provided all requested information, fulfilling my duty of utmost good faith under South African insurance law. If this history was material to your risk assessment, your underwriting process should have explicitly inquired about it or utilized the provided data. Your failure to do so does not constitute misrepresentation on my part. 2. Mismanagement of May 2025 Premium Payment The handling of my May 2025 premium payment, detailed in my email of May 27, 2025 (attached), was marred by inconsistent communication and processes, exacerbating the situation: May 6: You collected the premium. May 10: The funds were returned to my account. Your agent claimed no reversal showed in your system and promised a follow-up call on May 12, which never occurred. May 12: An SMS indicated the premium was unpaid. I was told a retry would occur on May 20 and to ensure funds were available, which I did. May 21: The debit was attempted a day late, after I had moved funds, assuming it had processed as scheduled. My wife’s accident occurred this day. May 22: I called, raising concerns about my active claim. Your agent, after consulting the claim handler, assured me the claim was “still pending” and unaffected by the payment issue, promising a call on May 26 to arrange payment (recording available). No call was received. May 26: I was told coverage would be pro-rata (May 26–31), a detail never previously mentioned, despite my repeated inquiries. Your policy wording states, “If we do not receive your premium by the due date or within 15 days after the due date (‘grace period’), you will have no cover for that month.” The accident occurred on May 21, within the grace period (May 6 + 15 days = May 21). Your agent’s assurance on May 22 that the claim remained active led me to reasonably believe coverage persisted. This miscommunication, coupled with my offers to pay immediately (which you rejected), suggests you should be estopped from denying the claim due to your own representations and delays. 3. Unprofessional Handling and Lack of Communication Your team’s lack of follow-through has been glaring: Promised call-backs (May 12, May 26) never materialized. Agents were unaware of prior requests (e.g., questioning my bank statement submission). Updates were only provided when I initiated contact, despite my urgent pleas. An email from Samantha Daniels (Badger Holdings) lacked context, forcing me to research her role, and her 14-day response timeline ignored the time-sensitive nature of my claim. This conduct falls short of the “soft landing” and customer-centric service you advertise, amplifying my distress. 4. Unfair Refund Proposal You propose refunding premiums “less any benefits paid.” My policy covers home contents (R255.88/month), two vehicles (R1,128.39 + R1,742.20 = R2,870.59/month), SASRIA (R19.75), totaling R3,146.22 monthly plus additional premiums for excess buster, platinum cover, and tracker payments. I have only claimed under the home contents portion, not the vehicles. The misrepresentation allegation pertains to the vehicles’ prior policy, yet I never claimed for them, and you had their details to verify. It is inequitable to offset a valid home contents claim (R6,649.00 for a TV) against vehicle premiums when the denial hinges on vehicle-related disclosure. 5. Unauthorized June Debit Despite cancelling the policy, you debited my account for the June premium. This unauthorized charge further demonstrates your lack of care and consistency. 6. Ongoing Lack of Response and Failure to Investigate the Complaint Following my formal complaint submitted on June 10, 2025, I received an acknowledgement from Cathy Murray stating the matter would be looked into. Yet, over 48 hours later, no response or update has been provided. I made multiple calls to your office on June 12, left messages, and was eventually informed by reception that Cathy Murray had stated she had no knowledge of the matter—despite confirming the previous day that she was reviewing it. This contradictory communication only reinforces the systemic mismanagement within your company and further erodes any remaining confidence in your process. Policy Wording Supports My Position “Dishonesty” Clause: This applies to “deliberate or dishonest withholding of information.” I provided tracker certificates with full vehicle details, which you could have used to verify their history. My actions were transparent, not dishonest—your failure to act on this information is not my burden. Unfair Deduction: Deducting the home claim from vehicle premiums violates the principle of severability, as the policy clearly delineates separate sections for home contents and vehicles. The alleged misrepresentation pertains solely to the vehicle section, not the home. Your “Treating Customers Fairly” commitment promises equitable treatment, yet this deduction is unfair. Requested Action I demand the following: Full Refund: Refund all vehicle premiums, excess buster, and platinum cover surcharges paid, with a detailed breakdown of the amounts. June Debit Refund: Return the June premium debited after cancellation. Response Deadline: Confirm the full refund in writing by close of business June 13, 2025, including the exact amount to be returned. Should this remain unresolved past the deadline, I will escalate the matter to the National Financial Ombud Scheme and seek legal recourse without further notice. I expect immediate confirmation that my concerns are now being handled by someone with authority to respond meaningfully. This matter has already been subjected to unreasonable delays and a concerning lack of accountability. Sincerely, Shaun Marais Policy Number: NYP3749440
106 replies
13 months ago
PETA3776136
I’m really disappointed to see the changes in Dotsure’s plans and the significant price hikes. It used to be an affordable and personalized service, but sadly, that seems to have changed. The jump in pricing is shocking—going from R529 to R1,358 just to include general wellness care for full coverage? That’s a massive increase. Not long ago, we could have three dogs on the top-tier plan for that price, including Excess Buster. Now, it feels like Dotsure has become just another typical insurance company, losing the customer-focused approach that made it stand out. It’s a real shame to see this shift. Dotsure used to be a company we could trust to provide great coverage at a reasonable price, but now, it feels like affordability and loyalty are no longer priorities.
53 replies
21 months ago
Exceptional Service from Semon Muller at Dotsure
I recently had the pleasure of working with Semon Muller from the procurement department at Dotsure, under claim number NYP3328174-00006. Semon was exceptionally friendly, helpful, and engaging throughout our interactions. She went above and beyond to ensure I understood every aspect of the process and made it clear that she was available for any questions or further assistance. In an industry that can sometimes be male-dominated, Semon's genuine concern for her clients and dedication to transparency stood out. She provided invaluable support, making me feel confident and well-informed. I truly appreciate her efforts and commend Dotsure for having such a remarkable individual on their team. Thank you, Semon, for your outstanding service and for looking out for Dotsure clients!
56 replies
23 months ago
Business is a **** | https://www.rosebanksale.shop/
DO NOT ORDER FROM THEM Ordered through their website https://www.rosebanksale.shop/track_order to the value of R949.00. Shipping included. One site says delivered and another that its still in transet. I queried as to where my parcel was and this was the response I received : Dear Customer, Thank you for contacting us. I checked the tracking details and it shows that the package has been delivered. In this case, we can provide the tracking number WUYOU**********, and you can check the status of the package through the following URL: https://www.17track.net/en. Or, you can check the status of the package at your local post office. Since the package has been delivered to the address provided at the checkout, we ship it to you in good faith. You can ask your friends/neighbors/family if they help you sign. Hope you receive the package as soon as possible. Thank you for understanding! I apologize again and hope you can receive your items as soon as possible. Best wishes, Customer service center The postal service in SA is no longer fully operational and I therefore cannot investigate where my parcel is, nor do I know which courier company actually handled the package. When you do into the link https://www.17track.net/en they ask you to pay a "refundable" amount and ask you for your bank card details. As far as I am concerned I appreciate the money in my bank account and will be doing no such thing. I shouldn't have to pay to find out where my parcel is. I find the lack of assistance to be unprofessional and a wash of the hands. DO NOT ORDER FROM THEM
0 replies
23 months ago
DO NOT ORDER FROM THEM
Ordered through their website https://www.rosebanksale.shop/track_order to the value of R949.00. Shipping included. One site says delivered and another that its still in transet. I queried as to where my parcel was and this was the response I received : Dear Customer, Thank you for contacting us. I checked the tracking details and it shows that the package has been delivered. In this case, we can provide the tracking number WUYOU3000002872, and you can check the status of the package through the following URL: https://www.17track.net/en. Or, you can check the status of the package at your local post office. Since the package has been delivered to the address provided at the checkout, we ship it to you in good faith. You can ask your friends/neighbors/family if they help you sign. Hope you receive the package as soon as possible. Thank you for understanding! I apologize again and hope you can receive your items as soon as possible. Best wishes, Customer service center The postal service in SA is no longer fully operational and I therefore cannot investigate where my parcel is, nor do I know which courier company actually handled the package. When you do into the link https://www.17track.net/en they ask you to pay a "refundable" amount and ask you for your bank card details. As far as I am concerned I appreciate the money in my bank account and will be doing no such thing. I shouldn't have to pay to find out where my parcel is. I find the lack of assistance to be unprofessional and a wash of the hands. DO NOT ORDER FROM THEM
0 replies
30 months ago
Lack of Assistance, Empathy and Totally Totally Shocking Customer Care
To Whom It May Concern, I am writing to express my profound disappointment and frustration with the recent experience my mother, Lorraine Deporah Candy, endured in her time of dire medical need as an Affinity Health Medical Insurance member. On the evening of Wednesday, 18th October 2023, at 9:00 PM, my mother suffered a severe heart attack. Swift action was taken, and she was transported to Melomedi Tokai after being stabilized by CMR. However, upon her arrival at the hospital, we were informed of the immediate need for substantial upfront fees to admit her and establish her care. To our shock, we were told that the admission fee alone amounted to a staggering R120,000, excluding any specialist consultations, diagnostic procedures, or treatments. I promptly contacted Affinity Health, as my mother was in no condition to make the call herself. It was at this point that our ordeal took a distressing turn. The operator insisted on speaking directly to my mother, despite my explanation of her critical health condition at the time. She proceeded to subject my mother to an unnecessary series of security questions, delaying any potential assistance. This entire interaction left us bewildered and appalled. The operator, inexcusably, claimed that this heart attack was a result of a preexisting condition. I must strongly emphasize that my mother, Lorraine, has never suffered a heart attack in the past. While she does have a history of high blood pressure, there is no previous heart attack to be found in her medical records. The lack of compassion and assistance during this traumatic experience was not only disappointing but wholly unacceptable. But especially insisting to speak to her and ask her security questions when the operator already knew she could not be assisted. I hereby demand immediate access to the recording of the operator's call on Wednesday evening, along with a thorough explanation as to why my mother's claim was rejected. Furthermore, there are pending claims on her profile that have not been settled FULL as promised. I require detailed information and resolution on these claims without any further delay. I also urgently request a consent form to be sent to my and my mothers email address to act on my mother's behalf, as she is currently incapacitated. I firmly instruct you not to contact her directly, as her health condition renders her incapable of dealing with your incompetence and lack of empathy during her time of need. For a prompt response and resolution, you may contact me at **********. This situation demands immediate attention and rectification. I trust that Affinity Health will take swift and compassionate action to address these concerns and restore our faith in your service. Sincerely, Taylor Candy-Marais ********** Good day Taylor Candy-Marais, Thank you for contacting us. As per POPIA, unfortunately we cannot disclose any policy information to any third party, you are welcome to inform the main member on the policy to contact us directly for further assistance. Thank you. It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods. Should you require any further assistance, please feel free to contact us on **********or reply to me directly. You are welcome to contact us on any of our other platforms: Whatsapp - ********** Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu Taylor Candy-Marais <***********> 10:13 (2 hours ago) to Affinity I sent you the consent form so I reiterate, I want answers Good day Taylor Candy-Marais, Thank you for contacting us. The consent form provided does not override the Protection Of Personal Information therefore we still cannot disclose any information to any third party. Thank you. It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods. Should you require any further assistance, please feel free to contact us on **********or reply to me directly. You are welcome to contact us on any of our other platforms: Whatsapp - ********** Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu Taylor Candy-Marais <***********> 10:21 (1 hour ago) to Affinity What do you need then, she cannot act in her own capacity so your lack of assistance is again shocking. I want someone to contact me on a resolution before I take this further Taylor Candy-Marais <***********> 10:22 (1 hour ago) to Affinity If i cannot act on her behalf and she cannot act on her behalf then what are my options????? What exactly do you expect me to do? And isn't the whole point of the consent form for this exact reason? this is seriously unacceptable!
0 replies
30 months ago
Affinity Lack of assistance and empathy
To Whom It May Concern, I am writing to express my profound disappointment and frustration with the recent experience my mother, Lorraine Deporah Candy, endured in her time of dire medical need as an Affinity Health Medical Insurance member. On the evening of Wednesday, 18th October 2023, at 9:00 PM, my mother suffered a severe heart attack. Swift action was taken, and she was transported to Melomedi Tokai after being stabilized by CMR. However, upon her arrival at the hospital, we were informed of the immediate need for substantial upfront fees to admit her and establish her care. To our shock, we were told that the admission fee alone amounted to a staggering R120,000, excluding any specialist consultations, diagnostic procedures, or treatments. I promptly contacted Affinity Health, as my mother was in no condition to make the call herself. It was at this point that our ordeal took a distressing turn. The operator insisted on speaking directly to my mother, despite my explanation of her critical health condition at the time. She proceeded to subject my mother to an unnecessary series of security questions, delaying any potential assistance. This entire interaction left us bewildered and appalled. The operator, inexcusably, claimed that this heart attack was a result of a preexisting condition. I must strongly emphasize that my mother, Lorraine, has never suffered a heart attack in the past. While she does have a history of high blood pressure, there is no previous heart attack to be found in her medical records. The lack of compassion and assistance during this traumatic experience was not only disappointing but wholly unacceptable. But especially insisting to speak to her and ask her security questions when the operator already knew she could not be assisted. I hereby demand immediate access to the recording of the operator's call on Wednesday evening, along with a thorough explanation as to why my mother's claim was rejected. Furthermore, there are pending claims on her profile that have not been settled FULL as promised. I require detailed information and resolution on these claims without any further delay. I also urgently request a consent form to be sent to my and my mothers email address to act on my mother's behalf, as she is currently incapacitated. I firmly instruct you not to contact her directly, as her health condition renders her incapable of dealing with your incompetence and lack of empathy during her time of need. For a prompt response and resolution, you may contact me at 072 380 0587. This situation demands immediate attention and rectification. I trust that Affinity Health will take swift and compassionate action to address these concerns and restore our faith in your service. Sincerely, Taylor Candy-Marais 072 380 0587 Good day Taylor Candy-Marais, Thank you for contacting us. As per POPIA, unfortunately we cannot disclose any policy information to any third party, you are welcome to inform the main member on the policy to contact us directly for further assistance. Thank you. It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods. Should you require any further assistance, please feel free to contact us on 0861 11 00 33 or reply to me directly. You are welcome to contact us on any of our other platforms: Whatsapp - 079 479 3230 Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu Taylor Candy-Marais <tcandymarais@gmail.com> 10:13 (2 hours ago) to Affinity I sent you the consent form so I reiterate, I want answers Good day Taylor Candy-Marais, Thank you for contacting us. The consent form provided does not override the Protection Of Personal Information therefore we still cannot disclose any information to any third party. Thank you. It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods. Should you require any further assistance, please feel free to contact us on 0861 11 00 33 or reply to me directly. You are welcome to contact us on any of our other platforms: Whatsapp - 079 479 3230 Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu Taylor Candy-Marais <tcandymarais@gmail.com> 10:21 (1 hour ago) to Affinity What do you need then, she cannot act in her own capacity so your lack of assistance is again shocking. I want someone to contact me on a resolution before I take this further Taylor Candy-Marais <tcandymarais@gmail.com> 10:22 (1 hour ago) to Affinity If i cannot act on her behalf and she cannot act on her behalf then what are my options????? What exactly do you expect me to do? And isn't the whole point of the consent form for this exact reason? this is seriously unacceptable!
0 replies
30 months ago
Urgent Complaint and Request for Immediate Resolution
To Whom It May Concern, I am writing to express my profound disappointment and frustration with the recent experience my mother, Lorraine Deporah Candy, endured in her time of dire medical need as an Affinity Health Medical Insurance member. On the evening of Wednesday, 18th October 2023, at 9:00 PM, my mother suffered a severe heart attack. Swift action was taken, and she was transported to Melomedi Tokai after being stabilized by CMR. However, upon her arrival at the hospital, we were informed of the immediate need for substantial upfront fees to admit her and establish her care. To our shock, we were told that the admission fee alone amounted to a staggering R120,000, excluding any specialist consultations, diagnostic procedures, or treatments. I promptly contacted Affinity Health, as my mother was in no condition to make the call herself. It was at this point that our ordeal took a distressing turn. The operator insisted on speaking directly to my mother, despite my explanation of her critical health condition at the time. She proceeded to subject my mother to an unnecessary series of security questions, delaying any potential assistance. This entire interaction left us bewildered and appalled. The operator, inexcusably, claimed that this heart attack was a result of a preexisting condition. I must strongly emphasize that my mother, Lorraine, has never suffered a heart attack in the past. While she does have a history of high blood pressure, there is no previous heart attack to be found in her medical records. The lack of compassion and assistance during this traumatic experience was not only disappointing but wholly unacceptable. But especially insisting to speak to her and ask her security questions when the operator already knew she could not be assisted. I hereby demand immediate access to the recording of the operator's call on Wednesday evening, along with a thorough explanation as to why my mother's claim was rejected. Furthermore, there are pending claims on her profile that have not been settled FULL as promised. I require detailed information and resolution on these claims without any further delay. I also urgently request a consent form to be sent to my and my mothers email address to act on my mother's behalf, as she is currently incapacitated. I firmly instruct you not to contact her directly, as her health condition renders her incapable of dealing with your incompetence and lack of empathy during her time of need. For a prompt response and resolution, you may contact me at 072 380 0587. This situation demands immediate attention and rectification. I trust that Affinity Health will take swift and compassionate action to address these concerns and restore our faith in your service. Sincerely, Taylor Candy-Marais 072 380 0587 I have since received the following response after consent has been given :"Good day Taylor Candy-Marais, Thank you for contacting us. As per POPIA, unfortunately we cannot disclose any policy information to any third party, you are welcome to inform the main member on the policy to contact us directly for further assistance. Thank you. It is the responsibility of the Policyholder / Insured Person to inform Affinity of any changes to policy information or communication methods. Should you require any further assistance, please feel free to contact us on 0861 11 00 33 or reply to me directly. You are welcome to contact us on any of our other platforms: Whatsapp - 079 479 3230 Live chat - www.affinityhealth.co.za Affinity Life Regards, Gabriel Mtimkulu " I reiterate I want answers
131 replies
33 months ago
No response to claims
No feedback regarding outstanding claims. No reason as to why they haven’t been paid out. I have followed up numerous times to which I get no response. 140723QRHZ3P 140723QRHZ3R 140723QRHZ2S
552 replies
34 months ago
SHOCKING!!!!! FRUSTRATING!!!!! UNACCEPTABLE !!!!
My account has been suspended. FedHealth didn't tell me that, the pharmacy did. Firstly no communication from them as a medical provider that WE the CUSTOMER pay a service for. Secondly, I have been given the following amounts since Tuesday that I owe. R816 I paid that, then I'm told on the weekend that I still owe R816 to which I sent the proof of payment again. Then as of this morning according to Lorrain Methula i owe the following Total Medivault outstanding as at: 10 July 2023 R10,618.00 (this is a forecast that goes up to 2024 - I won't be a client for that long) Total contribution outstanding as at: 10 July 2023 R1958.00 Then according to Mary R on the chat support i owe" Credit controller has advised outstanding amounts for contributions R1,958 and your vault R2,032.00" Please understand that i am happy to pay my account but WHAT AMOUNT???? Ive gone as far as doing a recon for them. This is simply unacceptable and when i ask for this to be escalated i get told it is what the credit controller has said. I want this issue sorted NOW. I currently have a 9-month-old not insured not because i cant pay but because Fedhealthy simply cannot get my account in order, this is unacceptable. I also get told that if i don't pay the amounts my account won't be reinstated, How the F#### am i meant to pay an account no one can give me a proper amount for. SHOCKING!!!!! FRUSTRATING!!!!! UNACCEPTABLE !!!!
180 replies
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