Active since May 2016
48
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48 reviews2 months ago
URGENT COMPLAINT: No Response on Ex Gratia Application Despite Full Compliance
Dear GEMS Complaints Team, I am writing to formally complain about GEMS’ continued failure to respond to my Ex Gratia application, despite the fact that I have comp**** with all requirements and submitted everything that was requested from me. I have followed every instruction given by GEMS, submitted the necessary documents, and made repeated follow-ups requesting feedback. To date, I have received no response, no update, and no acknowledgment. This lack of communication is unacceptable. What makes this situation even more distressing is that I am living with severe, ongoing pain as a result of my medical condition and surgeries, which GEMS is fully aware of and has on record. The Ex Gratia application is not a luxury—it is a necessity for my medical care and quality of life. The silence from GEMS has left me without support while I continue to suffer daily. As a member, I feel completely disregarded. GEMS’ failure to communicate or provide feedback shows a lack of care and urgency toward one of its members who is clearly in need. I should not have to beg for feedback after doing everything correctly and in good faith. I am requesting: Immediate feedback on the status of my Ex Gratia application A clear explanation for the prolonged delay and lack of response Urgent intervention, considering the severity of my pain and medical condition If this matter is not addressed urgently, I will have no choice but to escalate it further, as this ongoing silence is causing both physical and emotional distress. I expect a response as a matter of urgency. Yours sincerely, Refilwe Mvubu
168 replies
2 months ago
I'm dissatisfied and want to cancel
I'm so disappointed in absa I took an car insurance yesterday and I have been trying to contact them without success they either pickup and mute or hangup after many minutes of holding i am now at a position where I want to cancel the insurance immediately and continue with my current insurance as I don't have time or energy for this ,what will happen when I need them in future if this is what they are doing now call me ASAP 0678369629
112 replies
3 months ago
GEMS Medical Aid failed me
GEMS Medical Aid failed me. Before downgrading, I consulted GEMS to review my medical conditions and chronic medication and advise on a suitable option. I followed their advice. After downgrading, GEMS discontinued my chronic medication, claiming it is not covered. This is unacceptable. Why advise a downgrade that removes medication GEMS already knew I depend on? I submitted a motivation and my doctor submitted a motivation, yet the medication is still not approved. Despite my condition being fully recorded, I am being forced to complete repeated forms while I am not mobile due to multiple leg surgeries from a serious injury known to GEMS. This points to a broken internal system. Even though I am registered for PMB, GEMS continues to reject PMB claims and demands information already on their system. Members should not have to fight this hard for medication and claims. I demand urgent reinstatement of my chronic medication and immediate resolution of my PMB claims.
168 replies
3 months ago
I am disappointed ab...
I am disappointed about how TUT has handled the matter with my daughter after she was hospitalized and couldn't attend classes they expect her to pay for the fees for the same causes as when she came back they couldn't not make her catch up which is so disappointing I was expecting better from them since they are the ones who refered her to hospital she has submitted all documentation but they still want her to repeat the same causes and pay again which is not right im am a disappointed mother my number is 0678369629
0 replies
4 months ago
Gems is stressing me...
Gems is stressing me out I have been trying to get gems to pay claims for a procedure done on hospital ,but they are failing to pay for the medication although the procedure was approve and was cause by a condition that is registered as PMB they keep on sending me the same response even after I have explained this ,gems have all the necessary infomation on their system regarding this incident but they are just lazy to lookup and get answers they don't even pay for the wound clinic for wounds cause by the surgery in question this is really annoying and uncalled for.
106 replies
4 months ago
I have been experien...
I have been experiencing headache and heart ache with gems for the rest of the time i have been with them from claim being rejected for no reason and call not being picked up im called gems Thursday for an authorisation it was said that I will get feedback on Friday ,it is Saturday today nothing in my inbox I am trying to call they just pick up and don't talk,I am also waiting for payment for medicines claims they have been investing todate im just tired with gems and their poor service
159 replies
4 months ago
I am extreme frustration and disappointment with the service I've received from Gems this year
I am extreme frustration and disappointment with the service I've received from Gems this year. Despite my ongoing struggles with recovery from being shot and multiple surgeries, I've had to fight tooth and nail to get the support and claims paid that I'm entitled to. My mental health has suffered significantly, and it's disheartening to feel like I'm battling Gems instead of them being a partner in my care. Specifically, I have outstanding claims, including medicines prescribed in hospital, that remain unpaid. To add insult to injury, my option plan was changed without my consent or consultation, despite my numerous attempts to reach out and discuss my options. Given my history with Gems and the authorization obtained, I expect better service and support. I urge Gems to take ownership of these issues, process the outstanding claims, and contact me to discuss the plan change. I'm exhausted and frustrated, and I hope we can resolve these matters promptly.
159 replies
5 months ago
Poor service from st...
Poor service from staff i was there for an operation on the 22nd of October I have wound that apparently were suppose to have been seen in 10 days from the day of the operation i am learning this today when I talk to the Dr's receptionist that the nursing staff that was there were suppose to book me an appointment with the wound clinic ,what if the wound are septic as we speak some one must answer to this i am not happy with the services of this hospital in general, they need to improve or shutdown My number is 0678369629
71 replies
7 months ago
Im struggling to get...
Im struggling to get good service from gems I have been calling sending emails but I'm not getting any joy I have registered conditions that I have ongoing consultations and medication required for them but they are not authorising and paying the claims and medication I'm struggling with chronic pain from the Gun shot wound that has cause vein damage but I can't get authorization for the medication I am registered for PTSD but they are telling me I have to go see a GP to be referred to a phycologist when I'm in a situation that I cant even move or drive myself Gems is not considerate and they are not even communicating I even resorted to send massages to the counsel of medical aid schemes and hellopeter they respond with a template that is not saying anything about resolving the problems faced by the client I can't be paying medical aid and also pay doctors and medication out of my pocket Hope you assist me
212 replies
8 months ago
I am having a bad ex...
I am having a bad experience with gems I don't know how to deal with them anymore and calling them doesn't even help as you will be transfered all over but no help I have registered my condition but you are not paying claims you are not even authorising medication what should happen now ,I should die of pain and stress that you are giving me ,the life coach I have been talking to is no where to be found I don't know how to get results anymore your service is very very poor you need to improve or you'll loose you clients it is not nice to always fight for results especially in my condition
159 replies
Review Distribution
5 Star
2 (4.166666666666667%)
4 Star
0 (0%)
3 Star
0 (0%)
2 Star
1 (2.0833333333333335%)
1 Star
45 (93.75%)