AP
An P
Active since Jul 2016
9
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0
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Reviews
9 reviews11 months ago
Bonitas Not Paying According to Scheme Rates – Urgent Resolution Required
I am a member on the BonStart option and am experiencing ongoing issues with the short payment of claims, despite following all the correct procedures and receiving pre-authorisation where required. For GP consultations, my co-payment is R125. The full consultation amount charged by my GP is R571.50, with the Bonitas Scheme Rate listed as R446.50. Up until 12 May 2025, this was paid correctly – Bonitas covered R446.50 and I paid the R125 co-payment. However, since then, both my wife and I have seen the same GP, and Bonitas has only paid R357 per consultation. This is R89.50 less than the scheme rate. I’ve been repeatedly told that Bonitas pays according to the scheme rate, but clearly this is not the case. This discrepancy has occurred on at least three separate visits. In addition, I consulted with a Specialist after obtaining pre-authorisation from Bonitas. The Specialist charged R1100. The Scheme Rate for this consultation is R509.70, yet I have been told Bonitas will only be paying R244.70. I paid the full R1100 upfront and submitted the claim expecting reimbur*****t in line with the scheme rate – not a significantly lower amount. I have called the call centre numerous times, had the matter escalated, and was told most recently that the system was offline. Despite all this, the problem persists with no feedback or resolution. I am now tired of being given the runaround while continuing to pay more than I should out of pocket. I have the claim numbers, pre-authorisation reference, and supporting documents on hand but will not share them publicly. Bonitas, please contact me directly to resolve this matter urgently.
2 replies
52 months ago
I had a computer that completely failed, possibly due to the load shedding we've been experiencing
I had a computer that completely failed, possibly due to the load shedding we've been experiencing. I submitted a claim to Auto and General. The entire process was simple and the claim was finalised without any issues. I was expecting a long, drawn out process or for the claim to be rejected on some technicality, as has happened with a different insurer in the past. Instead, approval was granted quickly and without lengthy paperwork or processes. Charity Ventfolo handled my claim and was an absolute pleasure to deal with. She kept in contact with me to update me and assisted me with updating the claim when I realised I had not submitted the items correctly. The entire process was a real pleasure.
1 reply
57 months ago
Chronic Benefit Approval for Expensive Medicine
I suffer from eczema and cannot use cortizone on an extended basis due to bad side effects. My dermatologist advised me to use an ointment called Protopic which does not have the side effects of cortizone, but the drawback of Protopic is it's very expensive. I sent in a request for GEMS to approve the use of Protopic on the chronic benefit. Obtaining it on the Acute limit depleted the funds within a few months due to the cost. GEMS initially declined the request but stated they would reconsider if further information was provided by the Dermatologist. After submitting the first motivation I was approved for 2 tubes a year, which would be too little as I need Protopic monthly. After submitting a second motivation I was approved for Protopic monthly for an entire year. I am very thankful for this as it will allow me to keep the eczema under control. I would not be able to afford it on a monthly basis otherwise. Thank you GEMS for the positive outcome, I really do appreciate it.
2 replies
58 months ago
Excellent service and pricing
Great service and a good price. I had furniture items moved from my flat to a family members place. The gentlemen moving the furniture were quick and the items were delivered without any damage. They also offered help to move the furniture upon delivery to make it easier for my aged mother. Good covid protocols were kept during the whole process. The price charged was much lower than other companies I contacted. Would definitely use this great company again.
0 replies
58 months ago
Insomnia Claim Rejected
A dependant on my medical aid went in to our doctor for insomnia. He was advised the claim was rejected because insomnia is a scheme exclusion. I find it completely ridiculous that claims for a condition such as insomnia, which is being made worse by the Covid-19 pandemic, are being excluded by GEMS. I've requested an escalation and am awaiting feedback.
2 replies
63 months ago
Fantastic Service
I placed an order for 2 computer upgrades and the whole process was smooth, efficient, and pleasant. DC3 arranged to collect the computers and some new parts, assembled the systems, and dropped them off with me once done. The whole process took less than 3 days. Morne, the salesperson, was really great to deal with and was patient and very helpful. He matched the prices of companies who provided lower prices and provided good feedback. The computers worked as soon as I powered them on. I've placed several orders with DC3 and have received great service each time. They are consistently good and a pleasure to deal with.
0 replies
76 months ago
Unethical and Dishonest Company
I contacted this company when my geyser stopped working. Their website states there are no callout fees, yet I was requested to pay for the callout. The person that came in identified the wrong fault, attempted to charge over R4000 for a problem that didn't exist and would not have restored my geyser to working condition, used intimidation tactics, and then asked for their written quotation to be given back when I refused to pay for a 'free' callout. After strongly stating I would not pay he tried all sorts of tactics to obtain payment from me, including stating he had recorded our calls and that the two workers sent to me would remain on my property until I had made payment. This company is dishonest and unethical. Check other reviews on Hellopeter and Google, these support my claims.
0 replies
120 months ago
Great Service
<p>I was involved in a vehicle accident on the N2 near the Cape Town airport earlier this year. Nedbank Insurance was fantastic - I called them after I had arrived at the police station and they guided me through the process. Ashraf was particularly helpful, he made sure I was ok first, and then explained what I needed to do thereafter. Nedbank arranged for the vehicle to be assessed that very morning and got back to me the next day with an approval for the claim. The company they chose to do the repairs was equally brilliant (Toka Auto Repairs). A week after the accident the repairs were done and I was driving around as usual. The entire claims process was efficient and I encountered no problems at all. Great service from Nedbank Insurance overall.</p>
1 reply
120 months ago
Excellent Service
<p>I had a vehicle accident earlier on this year and my insurance company approved the repairs. The vehicle was hit from the back on the N2 near the airport and the entire bumper had to be replaced, along with repairs to some of the panels. Tokai Auto was brilliant - when I dropped the car off at their garage I was given a lift home at no charge, the repairs were completed within a week, and I received good feedback. Additionally, damage that wasn't part of the claim was also repaired (a scratch on the side of the car and bonnet chips) and the car was washed and cleaned before I collected it. Overall a great experience, I would recommend this company and would use them again in the future.</p>
0 replies
Review Distribution
5 Star
6 (66.66666666666667%)
4 Star
0 (0%)
3 Star
0 (0%)
2 Star
1 (11.11111111111111%)
1 Star
2 (22.22222222222222%)