NS
Nomhle S
Active since Jun 2012
9
Reviews
0
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Reviews
9 reviews5 months ago
Wooltru is not in the business of honoring claims
Momentum/ Wooltru is a true definition of pure capitalist, and in the business of not paying claims. We contacted the medical aid regarding getting braces for my 12 year old daughter who needs braces not for cosmetic but as a need as a child with bad dentals, On contacting them advised that we would need to get authorization for this, this by means of the dentist giving them some sort of motivation, the Dr wrote an entire thesaurus of motivation as well as a quote was sent. They then approved the fitting of the braces and gave us a break down of what would be paid by them at medical aid rates, which was 19000 and a couple of rands from a quote of 30000, the shortfall of 10 thousand would fall on us. The braces were fitted in August and we paid our part of the invoice. The Dr claimed for consultation as well and the fitment of braces. No payment was done, on our second visit the Dr advised he was never paid. On calling Momentum they advises the claims were not received, but proof from the Dr was sent to us, they then advised that the claim was sent to the incorrect email and couldn't be routed to the correct one, they advised that they would attend to it, but I had to call two more times just for the invoice on the 12th and 17th of Sept without having received a resolve to the issue, half the time when I called nobody seemed to even know what was happening with the claim call ref:698482596, I still had to send an email for the follow up after they has promised that they would make payment. On the 29th of Sept Dr sent me an email to advise payment was made however it there was a shortfall of R1580.05, which I had to make an arrangement to pay the Dr. September payment was rejected, citing incorrect codes were used, the Dr resubmitted and when we went for monthly visit again we were told that the claims for October were also not honored, this after the medical "scheme" sent us a nice letter advising of what would be paid by them, but now the entire account is now the responsibility of the member. on the 24th of Nov they were contacted and by email on the 24th and they responded on the 27th advising that the Dr must resubmit the claims under the correct email address, which baffles me is the company cannot reroute emails to the correct department for payment, and members and services providers have to constantly call to follow up and on these claims and we are taking from pillar to post. 26th Nov member called again ref: 709158486 and was told Dr needs to resubmit, which he did, 27th Nov ref: 708744767 an email was sent advising they called the Dr and advised the DOS 10/10/2025 and 08/11/2025 tariff 8890 was rejected as the claim do not refect on the dental system, on the same day this was sent it was forwarded to to the Dr because he knew that he has sent these claims, the Dr took it upon himself to call the medical aid and to his surprise he was not told what was said on the email but that the medical aid funds were depleted, call with Jerusha ref: 709316186,this message was relayed to us and we contacted the medical aid to get an understanding of how the story keeps changing, We were told by a Juliet that medical aid fund were depleted and therefore everything is now for the member's account. On asking to speak to the teamleader or manager of the contact centre we were told that they leave at at 16:00 when the call centre closes at 16:30 and I asked, who then takes escalation calls in this instance and she relayed that it is the consultants. I then proceeded to asked about the sudden funds are depleted statement, to which I was told that I should have read what they said on the letter where they advised that they would be paying the 19k that this is subject to the savings and I as the member should have read that and it was my responsibility to make sure that there are enough funds for this procedure, I then asked was it not the medical aids responsibility to advise the member on what is left in the funds when drafting the letter which is misleading in wording advising they are going to be paying 19k, only for them to take us from pillar to post and only at the end to say sorry, we will not be paying this, you should have read and now you are paying for this, there was no accountability whatsoever taking by momentum, only a blame game when a child is in need of braces and the member is paying the medical every month without fail. This in my opinion would have never happened to a white dentist and client, medical aids just what to milk capitalist company like momentum are only too happy to receive funds from black people and give them appaling services, while racially profiling black doctors who work hard to provide services to their patients, but everytime a claim comes, the scheme will do anything and everything possible not to pay them. We as patients are left with bills and yet without fail premiums are paid. This standard of service is totally disgusting to say the least, responsibility always fall of the patients but never on the company's because they have clauses that fill up books that they hide behind, while the CEOS of these companies are getting fat cheques and bonus. In my conversation with the agent, I requested that the TL call me to discuss this on the 28th of Nov, and they decided that my grievance is not important enough for them to give me call as I had waited the until 17:40 in the evening and nothing no call was received. and that is how members are treated at wooltru momentum.
0 replies
19 months ago
5 star Service
Service provided by Santam consultants is truly out of this world, they are constantly in checks with you when claiming for everything and anything, a big thank you for always practicing TCF on your customers, Sisanda Mtiki a big shout out to you for following through with me, during my claiming.. You are an assist to Santam! And I’m proud to be insured with Santam!
53 replies
29 months ago
KFC not what it seems..
The most terrible R56 meal I have ever had, Now i am not usually one to buy anything either than wings at KFC and today it just proved I should never try anything else..I went to the KFC on 14th Constantia Kloof Roodepoort to buy a meal called nugget box, and boy was i in for a horrible experience and surprise. After searching this meal on their website, i get there and they tell me there is no such meal, after getting whatever they thought was what I wanted, i went to open an extremely minute even my 10 year old would never be filled by it (R55) meal, Not only was the lettuce wilted and looked brown the sauce was a bland orange sauce with a bun as small as a R5 coin.. and the only reason why I finished is because I was super hungry, not that it filled me up., What a let down KFC.. Your advertising and menu on the net is definitely false advertising.
0 replies
30 months ago
Not inclusive, ****** and bullies!!
I went to this school to apply for my daughter in 2022 for the year 2023.. They placed us on the waiting list given the feederzone reason, I never got a call back from the school and the lady at reception blatantly told me that we are not within the feederzone, I work in Constantia Kloof by Flora Hospital, which is 1.3km from the school.. The lady at reception had no sense of humanity or compassion when dealing with parents especially us as black people, people and schools like this should not exist in our society, everybody wants a good education for our children and schools should be inclusive. I am going to take this to the Dpt of Education, this sort of behaviour and exclusion is unacceptable
0 replies
42 months ago
Refund SLA lies
I cancelled my motor and household insurance with A&G on the 18th of October for effective the 1st Nov, they had advised they had already sent magtapes to the bank for a debit order, i then agreed that they refund the premium , with them advising on a 3/5 working days SLA.. and the consultant said that because it is a same bank transaction it will actually not take that long, when contacting them on the 28th on the 6th day after the actual SLA I was met by stories that they had to verify the debit order was success and they will refund in 5 working days.. which will now be an SLA of 10 working days, when wanting to speak to the manager/team leader I was told that they are in a meeting, she than put me on hold to go fetch the manager only to return on the call with a “senior agent named Mutoli, she proceeded to tell that the managers have a meeting and he cannot come to the phone and I will have to wait for a call back, now after almost two years with this insurer and their below par service they continue to deliver that same even when a client is cancelling, I want my 1680.71 from this insurer.. they provide pathetic services to their customers, with over promises and under delivering.
132 replies
47 months ago
Nothing Pro about Proline
My car had been in a accident on the 29th of March 2022, and was taken by the towing guys to this penalbeater, I only received the car back on the 4th of May after an either month and a half with them they couldn’t fix the bumper properly and I had to bring it back,Moses who was assigned to my case was wonderful and great to deal with however Ursula who is a supervisor doesn’t even have the decency to great customers and shouts at staff in front of us, after having been told to bring my car in on the Wednesday the 18th May I was told that they couldn’t fix it at the time that I brought it in 11:30 am which was a time that they had given to means I had specifically told them what was wrong with the car from the day I had collected, then I was told to return on the 23rd @ 7:30 in the morning, which I did, however I was also told that they only offer shuttle services to people living within the radius of their business, funny though because initially when I collected my car they had a driver fetch me from home which was the same distance.. i was advised the repairs would be up until 14:30 and I had to sit at the premises an entire afternoon waiting for them to fix mistakes that couldn’t get right first time around after having my vehicle for a whole month.. what a disappointment this company really is.. with uncouth management
134 replies
52 months ago
Rubbish excuse for a school
My daughter goes to Spark Turffontein and to date we have not received her 2021 end year report card, this has caused anxiety throughout the schools holidays for both she and I, I sent an email to the school principal, her class teacher and schools operations manager and they don’t even have the decency to respond to my email even one that I had sent in December and another follow up yesterday.. I have lost total confidence in the school and wish I had enrolled my daughter else where. Spark is not all the bells and whistles it claims to be, on top of hiring teacher that can hardly articulate themselves and lack of diversity in their teaching stuff, this is the last straw for me with this bottom of the food chain school
53 replies
62 months ago
Less is more at McDonald’s
I visited McDonald’s at Jabulani Mall, besides their tendencies of always putting the wrong gender toy in my kiddies meal, this time because it’s month end they decided not to put in any condiments, nor serviettes and to top it off they put fries the suited for a happy meal in my regular adult Mcfeast deluxe order
0 replies
100 months ago
Billing while outside of hospital stay
My mother recently went in for knee replacement in September 2017, She was officially admitted on Monday 11th September, however they took in over night the Sunday the 10th. This day was not the official day of hospitalisation. However Lancet went an took bloods on the Sunday and billed my mother on her to savings which were already depleted. on speaking to them they tell me this is none of their business and I must take it up with the Dr and we are required to pay. this is not the first time I have had such and encounter with Lancet. their services is beyond bad to a point where , I do not want their services at any cost
105 replies
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