LC
Lauren C
Active since Aug 2009
32
Reviews
0
Industries
Reviews
32 reviews1 month ago
Zestlife Wrongfully Repudiated My Valid Co‑Payment Claim – Ignoring Their Own Policy Wording
Zestlife Wrongfully Repudiated My Valid Co‑Payment Claim – Ignoring Their Own Policy Wording I am extremely disappointed with Zestlife’s handling of my recent gap cover claim (Policy GAP1243808) for an out‑of‑hospital CT Lumbar Spine scan performed on 19 February 2026. My medical aid (CAMAF) authorised the procedure and app**** a standard benefit co‑payment — not a penalty. I submitted this co‑payment claim to Zestlife exactly as their policy requires. Zestlife has now repudiated the claim, using the incorrect reason that my medical aid “did not pay from major medical benefit”. This is not what their policy states, and their decision directly contradicts the clear wording in the documents they issued to me. 1. Their own policy explicitly covers co‑payments for out‑of‑hospital CT scans Zestlife’s 2026 Universal Gap Cover wording states: ✔ “We will refund the co‑payment… for out‑of‑hospital Procedures listed in Appendix A.” ✔ Appendix A specifically lists “Radiology – Computer Axial Tomography (CAT) scan.” [GAP email 16 Feb | Word] This is the exact procedure I had. There are no additional requirements such as “must be paid from major medical” or “excluded if the scheme pays from savings”. 2. Zestlife app**** the wrong clause The “major medical must pay first” condition applies only to specialist tariff shortfalls, not co‑payments. My claim was not for a shortfall — it was a co‑payment. Their repudiation misapplies the policy wording. 3. CAMAF app**** a normal co‑payment — not a penalty CAMAF’s pre‑authorisation clearly states the co‑payment amount and confirms it was a standard benefit design, not a penalty and not due to any rule violation. [GAP email 16 Feb | Word] 4. Their repudiation decision is unfair and contractually incorrect I followed all scheme rules, obtained pre‑authorisation, used a contracted radiology provider, and submitted all documents. Zestlife’s refusal to pay a co‑payment that their own policy explicitly covers is unacceptable. What I expect I request that Zestlife urgently: Reverse the incorrect repudiation; Reassess my claim using the correct Co‑payment benefit category; Process payment without delay. I have escalated the matter to Zestlife, Guardrisk, and my broker, and will involve the National Financial Ombud if required. Customers rely on Zestlife to honour their obligations according to their own policy wording. This experience has severely damaged my trust, and I hope Zestlife resolves this swiftly and professionally.
53 replies
2 months ago
Payflex system not identifying pic and ID, now i am the one who suffers and they dont seem to care
I am having issues using payflex because their system isnt verifying my ID and photo properly, I have been trying to sort this out for 2 days now and am now told I will only get feedback in a week!!! This is not acceptable as I now cannot use my payflex, it failed in a store the other day too and this is because of Payflex and their service providers fault, not my own. This needs to be sorted out, I use Payflex regularly and I also pay my account always on time. This is not right !!! and all i get is back and forth mails.
0 replies
4 months ago
Discovery app and website down, I get penalised.
I am super annoyed with Discovery vitality, they decreased my healthy food benefit cash back reward by a substantial amount, I have not been able to complete the vitality assessment as every time I go online (computer and app) to complete it, it is down, shows the following error: 500 Error Sorry, but an error has occurred. Our technical team is probably already hard at work trying to fix this problem, so please try again later. I should NOT be penalised by getting less cash back because of a Discovery technical issue. I phoned this morning to query it, the lady was of NO HELP and transferred me to another department who doesnt answer their phone. Why do I pay vitality if I am not going to get the full benefit? and why should someone be penalised with less cash back when the issue is on Discovery's side?? The email I am giving is the only one I could find on their site as there seems to be no email address for queries, and I just refuse to sit on hold wasting my airtime any longer; nor speak to a chatbot which won't help me at all. I pay a lot of money to Discovery every month.
0 replies
4 months ago
Absolutely appalling courier
I am waiting for a package from SHEIN, SHEIN gave Skynet the correct address but then Skynet had given the drivers the wrong address. They attempted delivery and it was on the other side of Cape Town. The customer care doesn’t answer my calls, they don’t pick up the tracking numbers (one provided by SHEIN and one them), I’ve had no feedback on when I will get my order and part of it is a gift and I’ve missed the date for the gift, this is shocking I’ve been following up non stop and know nothing about where my package is, 710228722276 is the SHEIN tracking number
0 replies
13 months ago
Netcare accounts department ignores me
Netcare accounts department specifically - They are sending me final demands for amounts due that were not for my account, when my medical aid tries to help me Netcare doesnt reply. They just keep sending these final demand messages, I owe nothing as the account was settled by my medical aid and when I query where the charge is coming from and ask for an invoice Netcare accounts department ignores me.
53 replies
14 months ago
CAMAF didnt deliver on promise
I am disappointed in the closing off a matter re a hospital claim. I had surgery on 28th Nov 2024 and CAMAF did not pay the hospital in full, i phoned and they advised that the hospital had overcharged and that CAMAF and the hospital would sort this out and was told to rest assured it would not be an issue. I now receive a demand for payment for overdue amount from the hospital so this matter has not been resolved. I had to phone CAMAF MULTIPLE times for my surgery accounts, it was a horrible experience throughout. I should have been resting and recovering and instead I spent a lot of time dealing with many accounts and medical aid queries, this is now 3 months and still not resolved. CAMAF needs to sort this out with the hospital, why am I having to follow up when I was assured CAMAF would sort it out?
71 replies
14 months ago
Oneplan is the best pet insurance company
I have pet insurance for both my dogs with Oneplan, they have been INCREDIBLE. Last year my girls life was saved because I could keep her in the vet to get well because of Oneplan, they’ve also been amazing with my other dogs illness resulting in hospital admission and surgery, the claims & authorization department are empathetic and kind, they respond to emails and call backs extremely quickly and took away at least one of the stresses when my pet is sick, thank you Oneplan. I am so grateful i am with this pet insurer. I can’t recommend them enough, my mother also has pet insurance with them and is also very happy with their service. They are professional, kind, quick and efficient and above all else, they care.
53 replies
16 months ago
Oneplan kennel cover claims process terrible and slow
Not impressed when claiming for when I am in hospital. There is cover available for when a pet owner is in hospital. It is either for kennel cost or if the dogs are cared for by someone then its R50 per dog per day. I enquired prior to my surgery and all I needed to submit was hospital documents to prove dates. I have since followed up twice via email and once via phone call. I now receive an email stating I need to submit proof of payment etc, for what? I had a pet sitter and my dogs did not go to the kennel and was told that I only need hospital documents to prove the dates for the claim to be processed. this is not acceptable.
56 replies
16 months ago
Clicks pharmacy table bay mall incredible excellent service
My experience with clicks pharmacy has been amazing. They are the best. Mike at clicks table bay mall is so helpful and explains medication to me whenever I need to ask, the service is excellent. I don’t use any other pharmacies, only clicks Table Bay mall Cape Town. Excellent !!!!
0 replies
16 months ago
Customer service email lack of communication re my order
I ordered a pair on Sunday 8th Dec. I followed up via email to customer service yesterday regarding when I can expect to receive the shoes, customer service rep**** to me on 12 dec stating I’d receive a response in 24 hours, the 24 hours have come and gone and I’ve received no feedback. Reference #6JQJGC8MQ
0 replies
Review Distribution
5 Star
8 (25%)
4 Star
0 (0%)
3 Star
0 (0%)
2 Star
5 (15.625%)
1 Star
19 (59.375%)