JO
Johan O
Active since Feb 2024
6
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6 reviews7 months ago
triangle of collusion between Winelands Radiology, Mediclinic Vergelegen ER, , and Dis-Chem/Kaelo Health.
Public Consumer Post (HelloPeter / Social Media) I need to warn the public about what I believe is a dangerous triangle of collusion between Mediclinic Vergelegen ER, Winelands Radiology, and Dis-Chem/Kaelo Health. On 4 August 2025, I suffered a severe shoulder and wrist injury. At Mediclinic Vergelegen ER, Dr. R. van Gruting suspected a torn rotator cuff. Yet: No urgent sonar or MRI was arranged (despite the machines being in the same building). My swollen wrist/hand was ignored — no X-ray, no immobilisation, no treatment. I was discharged with nothing more than pain tablets. Weeks later, my tendon has now retracted, my wrist remains untreated, and I face possible permanent disability. 👉 Here’s the pattern: Mediclinic ER refers scans to Winelands Radiology (different practice numbers). Winelands Radiology bills separately. Dis-Chem/Kaelo then repudiates authorisations, calling them “follow-ups” instead of emergencies. This system traps patients: they think they’re covered, but end up abandoned, untreated, and buried in medical bills. This isn’t just my story — it’s a systemic problem. How many other South Africans are being caught in this cross-referral trap? I’m calling on Council for Medical Schemes, National Consumer Commission, Carte Blanche, and the Minister of Health to urgently investigate.
0 replies
7 months ago
Patient Left at Risk of Permanent Disability After Medicross Negligence & Dis-Chem/Kaelo Refusal to Authorise Surgery
Patient Left at Risk of Permanent Disability After Medicross Negligence & Dis-Chem/Kaelo Refusal to Authorise Surgery FYI - PRESS STATEMENT TO BE RELEASED IN SEVEN DAYS Date: 13 September 2025 Somerset West, Western Cape – Pensioner Johan Martyn Oelofse has accused Medicross Vergelegen Emergency Centre and Kaelo/Dis-Chem Health of gross negligence, bad faith, and unfair billing practices after being denied urgent surgery for a severe rotator cuff tear confirmed by multiple medical reports. On 4 August 2025, Mr. Oelofse attended Medicross Vergelegen ER with a swollen wrist/hand and incapacitated shoulder. Dr. R. van Gruting discharged him without proper imaging or treatment — no X-rays of the wrist, no immobilisation, and only pain medication. Despite repeated complaints, no urgent stabilisation was performed. Subsequent reports from: Dr. Tamara Stephens (ER Acting HOD) confirmed an urgent suspicion of a full-thickness rotator cuff tear. Dr. Chris du Plessis (Head of ER Vergelegen) confirmed the diagnosis and noted surgery had been scheduled. Dr. Charl van den Berg (Orthopaedic Shoulder Specialist) warned that delays would cause tendon retraction, muscle atrophy, sleep disturbance, and permanent loss of function. Despite this, Kaelo/Dis-Chem Health repeatedly reversed prior authorisations, downgraded the emergency to a “follow-up,” and left Oelofse trapped with thousands of rands in bills for ER, radiology, and pharmacy services. Mr. Oelofse describes this as “entrapment into unauthorized services”: vague authorisation numbers are issued, patients undergo treatment in good faith, and the approvals are quietly revoked afterwards — leaving patients liable for unaffordable medical bills. “Forty-five days after my injury, I am still untreated. My tendon is retracting daily, my pain is escalating, and I face permanent disability. The ER doctor was negligent, and the scheme is acting in bad faith. They are destroying lives while hiding behind authorisation numbers,” Oelofse said. He has now issued a final joint demand to Medicross Vergelegen and Kaelo/Dis-Chem Health, holding them jointly and severally liable for: Medical negligence and breach of duty of care. Bad-faith repudiation of emergency claims. Entrapment and unfair billing in violation of the Consumer Protection Act. Mr. Oelofse is demanding: Immediate authorisation for surgery. Cancellation of all wrongful invoices. Full disclosure of tariff codes and Rand-value coverage. Written acknowledgement of liability and damages. Failing this, he intends to file a High Court damages claim, citing Oppelt v Department of Health, Western Cape (2016) where delayed emergency care was found to breach constitutional rights. For media enquiries, contact: Johan Martyn Oelofse Email: oelie1652@gmail.com Member: Dis-Chem Health Plus (Kaelo) – KH21361
0 replies
7 months ago
Patient Left at Risk of Permanent Disability After Mediclinic Negligence & Dis-Chem/Kaelo Refusal to Authorise Surgery
Patient Left at Risk of Permanent Disability After Mediclinic Negligence & Dis-Chem/Kaelo Refusal to Authorise Surgery Date: 13 September 2025 Somerset West, Western Cape – Pensioner Johan Martyn Oelofse has accused Medicross Vergelegen Emergency Centre and Kaelo/Dis-Chem Health of gross negligence, bad faith, and unfair billing practices after being denied urgent surgery for a severe rotator cuff tear confirmed by multiple medical reports. On 4 August 2025, Mr. Oelofse attended Medicross Vergelegen ER with a swollen wrist/hand and incapacitated shoulder. Dr. R. van Gruting discharged him without proper imaging or treatment — no X-rays of the wrist, no immobilisation, and only pain medication. Despite repeated complaints, no urgent stabilisation was performed. Subsequent reports from: Dr. Tamara Stephens (ER Acting HOD) confirmed an urgent suspicion of a full-thickness rotator cuff tear. Dr. Chris du Plessis (Head of ER Vergelegen) confirmed the diagnosis and noted surgery had been scheduled. Dr. Charl van den Berg (Orthopaedic Shoulder Specialist) warned that delays would cause tendon retraction, muscle atrophy, sleep disturbance, and permanent loss of function. Despite this, Kaelo/Dis-Chem Health repeatedly reversed prior authorisations, downgraded the emergency to a “follow-up,” and left Oelofse trapped with thousands of rands in bills for ER, radiology, and pharmacy services. Mr. Oelofse describes this as “entrapment into unauthorized services”: vague authorisation numbers are issued, patients undergo treatment in good faith, and the approvals are quietly revoked afterwards — leaving patients liable for unaffordable medical bills. “Forty-five days after my injury, I am still untreated. My tendon is retracting daily, my pain is escalating, and I face permanent disability. The ER doctor was negligent, and the scheme is acting in bad faith. They are destroying lives while hiding behind authorisation numbers,” Oelofse said. He has now issued a final joint demand to Medicross Vergelegen and Kaelo/Dis-Chem Health, holding them jointly and severally liable for: Medical negligence and breach of duty of care. Bad-faith repudiation of emergency claims. Entrapment and unfair billing in violation of the Consumer Protection Act. Mr. Oelofse is demanding: Immediate authorisation for surgery. Cancellation of all wrongful invoices. Full disclosure of tariff codes and Rand-value coverage. Written acknowledgement of liability and damages. Failing this, he intends to file a High Court damages claim, citing Oppelt v Department of Health, Western Cape (2016) where delayed emergency care was found to breach constitutional rights. For media enquiries, contact: Johan Martyn Oelofse Email: oelie1652@gmail.com Member: Dis-Chem Health Plus (Kaelo) – KH21361
53 replies
7 months ago
WARNING to all Dis-Chem Health/ Kaelo members
WARNING to all Dis-Chem Health/ Kaelo members I was injured in an accident on 4 August 2025. Three different doctors (including two heads of ER and a specialist surgeon) confirmed that I had a full-thickness rotator cuff tear requiring urgent surgery. Facts: ER Head Dr. Stephens: Confirmed positive tests and wrote:“Diagnosis requires surgical intervention – please authorize admission.” ER Head Dr. du Plessis: Confirmed the injury, noted that surgery was already booked for 25 Aug 2025, and that the surgeon motivated to Kaelo for urgent authorization. Specialist Dr. Charl van den Berg: Warned that every day’s delay risks permanent disability, tendon retraction, muscle atrophy, and loss of arm function. Despite all this,Dis-Chem / Kaelo REFUSED to authorize the operation, falsely classifying it as a “follow-up procedure.” Nearly 40 days later, I am still untreated, living on painkillers, unable to sleep, and my arm may become permanently useless. On HelloPeter (5 Sept),Dis-Chem promised they had “taken steps to resolve this” — but this was a hollow PR statement. Nothing has been resolved. Ask yourself: Would you trust your health or your family’s health to a company that ignores doctors, delays urgent surgery, and risks permanent disability to save money? Would you deal with Dis-Chem /Kaelo knowing how they treat their members? Rate them based on my case and share your view.
53 replies
7 months ago
Dischem / Kaelo Refused Authorized Emergency Operation – Pensioner Left in Severe Pain
Title: Dischem / Kaelo Refused Authorized Emergency Operation – Pensioner Left in Severe Pain Review: I joined Dischem Health / Kaelo in 2023, believing I would be protected in case of a medical emergency. In early August 2025, I suffered a serious accident that completely tore my rotator cuff tendon and left my shoulder, arm, wrist, and hand swollen and unusable. I went to Vergelegen Mediclinic ER in severe pain, unable to move my arm or wrist. The ER only did X-rays (which cannot show tendon tears) and discharged me with pain pills and a sling. Instead of treating me immediately, I was told to go for a scan two days later at a separate radiology building. Dischem / Kaelo authorized my emergency treatment, then revoked the authorization, claiming my surgery was a “follow-up” procedure — despite medical evidence that urgent surgery was required. Multiple specialists warned that every day of delay risks permanent disability, yet my claim was repudiated. As a pensioner, I cannot afford private surgery. I have been left in constant pain, losing use of my arm, and at risk of permanent disability because of Dischem / Kaelo’s negligence and refusal to honor their authorization. They admitted causing me “distress and urgency” and apologized for “poor communication” — but apologies don’t fix a torn tendon. ⚠️ Question to other consumers: 👉 Would you trust Dischem / Kaelo to protect you in a real emergency, knowing how they treated me? 👉 How would you rate Dischem Health / Kaelo’s reliability and ethics based on this case? 📌 This matter is being escalated to the Council for Medical Schemes and prepared for legal action for damages.
53 replies
8 months ago
DISCHEM MEDICAL INSURANCE A RACKET - BEWARE OF THEM!!
My name is Johan I have been a member of Dischem Health Medical Insurance since 2023. I am 63 years of age. We just moved down from East London to Helderview ,on the night of 3 August 2025 I was carrying a box, it was dark, I had an legitimate accident, I accidently slipped and fell down and injured my left wrist and arm would not move sideways - the next morning x rays confirmed I tore my rotator cuff clean off , which explained the excruciating pain. I took a hot shower, attended to my visible wounds and took heavy pain medication. Around 11:45 I could still not sleep, I could no longer bear the pain and my pensioner wife googled the nearest ICU, and drove me to the Vergelegen Medicross. We followed the Emergency signboards, I noted the parking lot was dead quiet, with very few parked vehicles, once we arrived at the Emergency Department, there is a tar drive through under roof area, but the aluminium entrance doors was locked, we looked inside, but did not see anybody through the locked glass doors, eventually we had to leave without being able to see any hospital staff. The next morning, 4 August 2025 at 7:45 we went back to Vergelegen Medicross , we were directed to another entrance on the back of the building, the place was very crowded, I waited about an hour before I was asked to register on their computer, the reception staff contacted Dischem Health / Kaela and first obtained reference number 389706756 which authorized me to see a Dr. van Gruting, after waiting close to 3 hours ,who send me for X-rays, he mentioned x-rays do not show bone break, his referral report prognosis was "suspected Rotator cuff tear" he wanted to send me for a sonar scan in ER but there was a problem and the one machine was broken, dr. said they would not be able to do the scan immediately and he gave me a medical referral letter on the Emergency Department letterhead stating Winelands Radiology Diagnostic Radiologists must book me for the scan ER was not equipped to do at that stage, the scan appointment was only two days later, on 6 August 2025 at 11:30. I was issued a script for pain medication and told once the scan was done the scan Dr. would forward his report to the ER Dr. Dr. van Gruting who would decide how to deal with my ER injury. With a lot of effort I had to personally phone and send no less than 5 x email's to Dischem Health / Kaelo - I eventually managed to get authorization, reference nr. 389 706 756. On 6 August 2025 Dr. S Scheepers examined the x-rays and confirmed Dr.van Grutind from ER's prognosis that my Rotator Cuff had indeed torn right off the bone , he confirmed the sonar showed there was heavy inflammation , fluid distention etc. which Dr. Scheepers explained was the reason for the excruciating pain. Every time I move my arm it feel like there is a knife in my shoulder that is twisted. Next step I was told to arrange an appointment with Charl van den Berg a specialist orthopedic and shoulder Surgeon for 12 August 2025. After five plus e-mails and calls Ella from Dischem /Kaelo eventually issued me with Authorization reference 389706756 second approval 05037207 , fortunately I recorded our conversation, BECAUSE ON 13 AUGUST 2025 THE SUPPLIER SEND ME AN EMAIL THAT THE AUTHORISATION WAS WITHDRAWN AFTER I TOOK THE EXPENSIVE SCAN. I am of the opinion it is highly embarrassing to give authorization then without consulting me or the Dr. to one-sidedly with draw their authorization and explicit undertaking to pay the account in full... beware of this if you should consider dealing with Kaelo/Dischem!! When I arrived at Dr. v d Bergs rooms for my appointment I had to pay the consultation fee of R1200.00 up front!! On 12 Aug 2025 Dr Charl van den Berg send a report to Dischem Kaelo his finding was there is a full thickness tear, he confirmed the previous two doctors was correct and that the left rotator cuff tendon was cleanly torn in half, and he warn that if the shoulder is not operated as a matter of priority it would lead to further tendon retraction, muscle atrophy and progression to an irreparable tear, leading to PERMANENT DISABILITY . The shoulder specialist state an operation is the only way to restore use of my arm, restore shoulder strength and to prevent chronic pain, etc. People I would seriously warn you not to trapped by the lower rates to belong to Dischem/Kaelo. As a patient in extreme pain you will have to try and get your own authorizations approved from Dischem/Kaelo. After begging and threatening case managers they will reluctantly issue authorizations, which they then reverse , and you are stuck with the account. My operation was scheduled for 25 August 2025 I have send approximately ten or more emails and all three the doctors reports and recommendations, after a week lapsed the surgeon and the theater cancelled the theatre booking for lack of authorisation. Dischem/ Kaelas reason for not approving the emergency operation BELIEVE THIS OR NOR - THEY SAY BECAUSE THE ER DEPARTMENT COULD NOT HELP ME BECAUSE I WAS NOT TREATED IN FULL AND NOT IMMEDIATEDLY!!! THE DELAYS WAS NOT ON ME THE PATIENT'S SIDE, THE HOSPITAL COULD NOT DO A SCAN DUE TO A BROKEN MACHINE AND/OR BEING TOO BUSY , AND NOW FOR THE LAMEST EXCUSE, BECAUSE THE ER DR VON GRUNTING DISMISSED ME FROM ER, THE MOMENT I WALKED OUT THE DOOR MY CLAIM WAS REPUDIATED BECAUSE THE ER STAFF DID NOT HAVE THE CAPACITY TO TO AN ER SONAR AND TO OPERATE IMMEDIATEDLY. BE CAREFULL PEOPLE - I HAD AN ACCIDENT, MY SHOULDER DAMAGED BEYOND USE, DISCHEM DELAY AUTHORISATIONS AND GIVE LATE AUTHORISATIONS WHICH THEY REVERSE AS THEY PLEASE, WHY DID THEY GIVE ME AUTH TO GO FOR E RAYS, TO GO FOR SCANS AND AUTH TO SEE THE SHOULDER SPECIALIST TO TURN AROUND NEARLY 20 DAYS LATER AND SAY THE PATIENT DID NOT ACT SPEEDILY ENOUGH THAT IS WHY THEY ARE PULLING BACK YOU WILL BURN YOUR FINGERS WITH DISCHEM KAELO THEY JUST WANT YOUR MONEY JOHAN
1 reply
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1 Star
6 (100%)