Affinity Health Complaints - Run if they come close

In February 2019 I decided to take out dental insurance to cover me in case of any dental problems I may face. After some research I selected Affinity and contacted them to put a policy in place.

The idea behind this was to help save money in case of any dental health problems I may face in the future. Was this a good idea, was it good use of my money and time? Well let us look at the facts.

Had I not taken any action then in March 2019 when I suffered from a tooth infection I would have had to pay a dentist R300.00 to sort it out, and would now, once again be in good dental health.

However I did have a dental plan. So I contacted my dental insurance company. For 4 months they ignored all my attempts to contact them and to get approval to see the dentist, by this time the infection had spread to a second tooth, and the first tooth had become so infected it had broken. Eventually ONLY AFTER threatening to go to the Ombudsman did they take action. So far it had taken them 6 weeks between receiving the quote and giving approval, due mistakes by them like
A) Refusing cover for the root canals and crown claiming I was not covered for these (which I was)
B) Them making false claims regarding the amount quoted by the dentist in an attempt to make me pay more
C) Them making false claims that the dentists had used amounts above the recommended amount to try charge me more
D) Them refusing to accept responsibility for their lack of service and breach of contract.
all the while the situation are getting worse

well let us see how honest and reliable they are

They claim
. Please note that the underwriters’, product suppliers’ and intermediary details along with the compliance department and the Ombudsman’s information will be in the documentation that follows.

Ombudsman details are nowhere to be seen in their documentation

They claim
4.1 The following Benefits are subject to a 1 (one) month Waiting Period from Commencement Date: - Emergency Examination - Infection Control

According to an e-mail received from Gabisile “Please note that your inception date is the 01/02/2019 , we do have a 3 month waiting period for dentistry. Should you have received your cards in March 2019 you would have still been in waiting periods for the selected procedure , therefore the procedure / quotation would have been declined due to waiting periods.”

They claim
you will receive your welcome pack, together with your membership card within 28 working days following your first successful premium collection

First premium paid 31/01/2019
Welcome pack and membership cards received: Late June 2019

They claim


This is R2.00 less than scheme tariff counter to their claim

They claim

AMOUNT QUOTED Infection Control 20.00

This is R1.00 less than scheme tariff counter to their claim

LASTLY the following

Service code Description Amount Quoted Amount authorized Member
8376 Core Build up 764.50 0.00 764.50 303 -pre autherisation is declined

They have yet to give any reason as to why it was declined, even though it is covered by the policy

They Claimed that root canal and crowns were not covered
Only after another threat to go to Ombudsman did they correct this.

CONCLUSION, truth, honestly, accuracy and professionalism is beyond their scope, they have no problem lying to their client’s make false and fraudulent claims.

Thus a R300 tooth infection that should have be sorted out within a few days become and month nightmare of pain, ridicule and great financial expense.

After a final letter to them threatening to go public, as I refused to Pay R3800.00 for their incompetence they came back with a new offer that still required me to pay in almost R 1700.00 claiming they had gone above and beyond to accommodate me, what an insult.

The reality of the situation is that I do not have R1700.00 to pay for the portions they refuse to cover. The broken tooth is one of my front teeth and as become a very sharp point that keeps cutting my lips. As I can not cover this cost and have it repaired the only choice left is to have it removed and spend the rest of my life with a missing front tooth, facing embarrassment and humiliation. All this because I made the grave error of signing up with Affinity health.

MY RATING OF AFFINTY, DRC and African Lion who were aware of what was going on but did nothing even though they are the underwriters for Affinity

Honesty 0/10
Integrity 0/10
Accuracy 0/10
Friendliness 0/10
Professionalism 0/10
Speed of response 0/10

I can with all honesty say that I have never received such shoddy service in my life, I can assure you that every effort will be made by myself to ensure that no one else ever makes the mistake of taking out a policy with these companies, this has been the most expensive, physically and emotionally painful experience of my life and an error of judgment on my side that I will make sure to rectify.

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