Dental Risk Insurance complaint

<p>2017/06/09 Hallo Peter.</p> <p>With this letter I, Eurika Vos Id no ********** 114087,  Dental Risk Insurance Policy number SDR ********** , submit a  complain regarding abovementioned policy and the breach of my contract please note documentation attached .</p> <p>On 04/10/2015 I received my dental contract with start date on 01/11/2015(pg A1+2) with premiums of R 395.00</p> <p>p.m (pg A1) and orthodontists benefits of R 25000.00 per member p.a (pg13). According to the policy wording (pg 1) the</p> <p> Insurer (Guardrisk Insurance Company), the administrator (Dental Risk Company) and the product intermediary (Thethani Financial Services) is mentioned, not DRUM (Dental Risk Underwriting Managers) or Griffin Insurance Management. According to pg 8(policy termination) 30 days written notice must be given with regards to any changes, neither was I informed telephonically, via SMS, email, fax or post regarding the above mentioned changes or that the contact details of Thethani Financial Services as stipulated in my correspondence and contract received has been chanced and the stipulated numbers does no longer exist or notifications regarding changes of the administrator, underwriters and participants, ( Pg 9 of the contract states that any upgrades can only be done after the first 12 months. Pg 10 states that if any information about the product intermediary, administrator or insurer was given orally, it must be confirmed in writing within 30 days, this was not done either.</p> <p>Only the following emails were received by me with regards to the policy:</p> <p>a)     04/10/2015- Welcoming, with policy contract,</p> <p>b)    24/10/2015- Benefits and policy certificate (BE) and member contribution letter (B 1-3) (premiums 2016 and tax certificate).</p> <p>I would like to mention that according to my policy contract/ policy schedule DRUM (Dental Risk Underwriting Managers) was never mentioned nor have I received any correspondence neither telephonically, via SMS, email, fax or post that Thethani Financial Services are changed to DRUM or Griffin Insurance Management, yet the abovementioned companies claimed (DRUM & Griffin) claims that they send me correspondence regarding my benefit changes for 2016 & 2017(C1+2). This so called send correspondence is in direct violation of my policy contract due to pg 10 4.2 of my contract, where I was never informed and also in violation of my policy contract pg 9 N, where I’m refused to take a better option within 12 months from starting date.</p> <p>According to Franco Schultz from Dental Risk (the administrator) the benefit changes within 19 days of my policy start date on 1/11/2015, my benefits decreased (orthodontist) from R 25000.00 to R 17000.00 per member per life time. As abovementioned I was with held package upgrade within 12 months. Neither was I given written or verbal notification from the administrator of any changes of benefits and neither can they proof that they send me the benefits changes, to accept any changes or to continue with the policy. Because I didn’t receive any correspondence from the administrator, I could not accept the changes, cancel the policy or upgrade to Gold as per comment made by Franco Schultz in email dated 07/06/2017. This is the first date I received correspondence with regards to the benefit changes was it not brought under my attention by the orthodontist on 06/06/2017. My understanding of FAIS is that they (Thethani Financial Services) can increase my premiums but is not allowed to decrease my benefits, neither make any changes to my contract without my telephonically, via SMS, email, fax or any written consent and approval only by the assumption of (Thethani Financial Services), please take note all the above mentioned was also done by (Thethani Financial Services) after the 7 to 14 days FAIS cool off period 19 November 2015.</p> <p> Regards,</p> <p>Eurika Vos</p> <p>Email: **********