TF
Tamiah F
Active since Mar 2026
2
Reviews
0
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Reviews
2 reviews1 month ago
Poor Communication and Administrative Failures
I obtained authorisation for a gynaecologist consultation and was advised by the agent that if the provider requested an upfront payment, I could claim it back. I was never informed that paying upfront was a standard requirement. After the consultation, I paid the provider and the claim process has since been handled with conflicting information and delays. Shortly after, my account was suddenly suspended for non-payment, preventing claims from being processed. I immediately arranged payment as instructed, and the debit went off from my bank account, but the insurer keeps saying the payment is not reflecting on their system and my account remains suspended. Despite multiple calls and reference numbers, the matter remains unresolved. I followed the instructions provided by their agents, yet my claim is still not settled and my account status has not been corrected. This level of miscommunication and poor administration is unacceptable.
53 replies
1 month ago
Authorisation Confirmed, But Not Honoured
I received written authorisation confirming R2,000 was loaded to my specialist limit. At no point was I told I needed to pay upfront and claim back at the Kaelo tariff, either in writing or during my call to the contact centre. After paying R300, I’m now being told I must settle the account in full and claim back at a limited rate. The insurer has even admitted staff need further training to communicate this properly. This is unacceptable and unfair, as I acted in good faith based on the authorisation provided.
53 replies
Review Distribution
5 Star
0 (0%)
4 Star
0 (0%)
3 Star
0 (0%)
2 Star
1 (50%)
1 Star
1 (50%)