Affinity Health Insurance Complaints - Unfair rejection to pre admission

Name : Morne
Phone (Optional) : 0712368634
Your Policy Number (Optional) : 2863932062


We joined your company 1/2/2018. My son Jaden Vorster (02) was taken to a listed doctor of YOUR choice in mid April due to severe pain in his left middle finger. Dr Westerman in BHS diagnosed him with a spider bite and was treated with 2 types of antibiotics . On the 9th of May 2018 Jaden started complaining about severre pain in his finger again. As Dr Westerman was not available we took him another dr Jacobs NOT listed and paid R 400-00 consultation fee. After consultation he referred my son to Dr Stefan Colyn an Orthopedic Surgeon at The Wilgers Hospital. He did a sonar and claimed that this is a ganglion and must be removed at the soonest. We cannot acknowledge the severity of this diagnosis and Dr Colyn recommended that he had to remove this at the soonest. We phoned for pre authorization on 16/5/2018. They rejected this admission due to the fact that Jaden had been at Dr Westerman Mid April which falls out of the three month period BUT this was a totally different diagnosis to begin with AND he was seen by Dr Jacobs on the 9 th of May which falls WITHIN the 3 month period. THIS IS NOT ACCEPTABLE !! The service we received via telecommunication could not be worse, No one is capable of assisting in a proper manner and refuses to give any other contact information of a Superior. All they have to say is that relevant contact details are noted on rejection letter that will be emailed - but we have been waiting for two days for this letter. In the mean time my son is in severe pain and his admission had to be cancelled. I trust you acknowledge the urgency of this matter and that response will happen as soon as possible. We tried to log a complaint on your system but without any success aswell. Morne Juan Lane 071 236 8634

Please allow me some time to investigate the matter .

It will be much appreciated. I will stay online and await your response. The review on Hello Peter makes me very nervous ....

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mornelane ( on 18/05/18 )

Attitude : Agree Send Mail

Okay so here is an updated repot on this whole situation ....

Great, because your online services is not of use at all, not even to talk about the telephone services.

My child was supposed to be admitted on Monday …

071 236 8734
083 387 2698

From: Vanessa [mailto:[email protected]]
Sent: Friday, May 18, 2018 2:15 PM
To: Heili Lane
Cc: [email protected]; 'Morne Lane'
Subject: Re: COMPLAINT - MJ LANE...

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