Active since Mar 2009
Totally pathetic service as usual. It's like I have to load you all the time just to get the service I am paying allot for. My husband went for a corneal graph in February. They haven't paid the doctor to date for the cornea. I called and spoke to 3 agents - tembele - 16/02/ashante/ lulama - 8 April who assured me they would call the accounts department and sort this out. They advised the accountant is not providing the correct nappi code. This was last week, nothing has been resolved to date, and now the doctor is handing me over to the creditors for payment. Can this can resolved urgently. Please find the REF no's below REF - 11941137068 REF - 11914415431
Phoned in December already, spoke to Musa Nethononda. Firstly they had me listed as someone else. She was supposed to fix it and get a consultant to call me. To date I am still waiting. Scorpion should look at changing their process because I even sent an email and got no response till today. Terrible service. There should be SLA's in place, and clearly you not reaching them
I have been battling to get a consultant to assist me. I called over 5 times, got cut off like 3 times, and the other 2 times they said a consultant will contact me, still nothing. I even emailed them, came back undelivered. I need assistance urgently.
I am a member of Discovery Medical Aid on the Essential Delta Core Plan since 2007 and I am extremely disappointed with the handling of my care. I suffer from trigeminal neuralgia, one of the most painful conditions known, and rely on a specialised procedure called balloon rhizotomy for relief. This procedure was previously approved and funded twice, but my most recent request was suddenly rejected at the last minute, despite no change in my medical condition. My treating neurosurgeon is now unavailable for the next five months, leaving me with no access to the care I urgently need. Balloon rhizotomy is only performed by a handful of specialists in South Africa, and the medical aid has refused to help me find an alternative provider, effectively leaving me in excruciating pain. This is unacceptable. A medical scheme should facilitate access to life-changing treatment, not block it. I urge Discovery Medical Aid to review this case immediately, authorise the procedure, and assist me in finding a qualified specialist, as required under their obligations to members. My health and quality of life has seriously deteriorated and is continuing to get worse. Treat us like people and not like cases.
Firstly consultant loaded the incorrect plan. I got the quote from the Opthalmologist that he is charging 400% over the scheme rate. I called to find out what I'm covered for because clearly I don't have that kind of money lying around and that's why I have gap cover only to be told they cannot assist till the procedure is done, then only can they assess the claim. What nonsense. I'm supposed to pay upfront approximately R90000, with no guarantee of getting any of it back. Why do I have gap cover then. Atleast medical is able to tell me how much they cover, why can't gap cover do the same. They never told me all this when they offered me the cover. All I want to know is to look at the quote and tell me what they cover, is that so difficult. If that's the case they must cancel my cover and give me back all my money because they falsely advertise their benefits. They expect me to do all the research, can't even assist with a written quote. All they can do is take my money and then look for any excuse to reject the claim
Claims refuse to refund me the co-payment I was forced to pay at a pharmacy that is not a bankmed designated pharmacy. I was forced to go there since my pharmacy did not have a very important chronic medication that I have to take. I cannot understand this, since I have allot in my savings, and I'm not even allowed to use it as I please
Totally disappointed in the service I received. Not 1 of my cases did Scorpion win. They keep making it my problem to get engineers and get quotes, so what is the purpose of having them when I need to do all the groundwork. I have been with Scorpion for over 3 years, made only 2 claims, and only 1case did they actually do a bit of work. Case is going on from the time I joined. They contacted me like a year later, now they want to charge me R4000 when the claim is about R7000, how does that make sense. Real useless amateurs they got handling our cases. I just want my 3 years payments I made since I got no service
I cannot understand why we need to go see a doctor every 6 months and pay consultation for chronic conditions. I was told by a consultant that the consultation for chronic medication should come off chronic benefits. I called today to be sent from pillar to post, started at claims, was put through to some medi-clinic dept to be put through to the chronic department to be told they only deal with chronic medication. Why is the switchboard or claims consultants not trained to route the calls to the correct department. I cannot be the first person having this problem.
Spoke to a consultant on the complaints team at Scorpion. He assured me someone was going to call me back, and nothing to date. I do not even have the consultants name for this case. I cannot understand why this case cannot be fought in Small claims court. The amount we claiming is under R10 000. Can someone get back to me soon. Case is carrying on since last year. Do you only look at the case once a month. Ridiculous if that is the case.
Totally disappointing service. They don't tell you when they taking your money they have amateur's fighting your case. I asked for the best cover but now they refusing to fight the case saying i have used my full limit. I have 1 case open since last year so I would like to know what my yearly limit is. I thought the case was clear cut but apparently not. I cannot see for what we need an engineer when the first installation was not done properly. The same contractor came out and did it correctly the second time, so clearly it was poor installation the first time resulting in 2 glass panels cracking when the motor came crashing down. All they did differently was put more *****s. Scorpion cannot even fight a simple case like this. Want to charge us for the engineers report even though we got quotes from other garage door installors confirming the reason for the motor coming down was poor installation.
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