I would like to complain about Resolution Health as they are useless when it comes to covering their clients.
I went for my annual checkup (13 March 2012) at my gynecologist and as a routine check they did a pap smear. Then when I got home my husband and I decided to apply for medical aid as he will be working at heights as a rope tech and it would just be safer in the long run.
Then we applied for Medical Aid and we got accepted with Resolution Health on the 1 April 2012. Just before they accepted us, my doctor phoned me that I need to come into his rooms again to discuss the findings in the pap smear. We made a booking and I saw him again on the 27 March 2012 where he told me that there are cells that needed to be removed otherwise they will turn cancerous in the next 3-4 months.
The very next day I went to the police to make a affidavit and got all the notes etc from my doctor and sent it to the medical aid to inform them. After they had received all i was still approved for membership without any exclusions.
My doctor in the mean time gave me a date for the Operation which was supposed to be yesterday 12 June 2012.
I sent all my pre-authorization forms to them etc and got an email back from them almost 2 weeks later saying I have been terminated do to non disclosure of factual clinical information...
This is not acceptable as they have now waited 3 months of me paying my premiums etc and now all of a sudden they have a problem covering me when I need coverage.
There reason is that I did not let them know when filling in my Resolution Health Application forms about the visit to my gynecologist. How should I have known at the time there was something cancerous inside of me? Eg: Should I have told them about a doctor’s visit I had a month ago because I had a headache and then 3 years later its brain cancer and then they won’t cover me because I did not let them know about the routine doctor’s visit.
I am at the end of my rope and my broker is doing everything in her power to get through to them because she knows they are wrong and they are just not coming to the party.
I am not very good at explaining my problem but have done so as best as I can.
In June Resolution Health confirm that they will pay claims still outstanding since Dec '10. As per the supervisor this claims will be paid within 7 working days and comfirmed that this is a mistake on their side! Since then I have not received any feedback from Resolution Heath, I have been sending emails on a weekly (daily) basis - no feedback. When I phone them I get empty promises that someone will phone me back and that the problem will be sorted immediately and the accounts will be settled.
Nothing happens, Now I am sitting with a bad credit record because of Resolution Health. I don't think this is a way to treat client that pays their debit order every month on time??????
I will not recommend them to anybody - They WILL let you end up in financial trouble!!!
They have long stories to pay out my money they need to pay me after I've paid the medical bills eg. Hospital and gino for the birth of my baby. Every time it is a different story when I phone them. If you can help my no is [protected]
I am really not impressed with Resolution health and think that you guys need to brush up on your customer services as well as your communication skills.
On the 17/12/2009 I received a text message on my cell phone stating that my income details for 2010 has not been received and that my premium will be defaulted to the highest premium. I have not received any notice/letter or even a call to say that my details should be updated, when I tried calling the help line I was kept on hold for more than 10 min on several occasions so my query was still not attended to. Now my question is “how can Resolutions just assume that I was notified about any changes to my premium or that my details should be updated?” and how pathetic is this company to send me a random sms notifying me of this change? Now it’s not my intent to shoot the messenger but this is really not acceptable I think Resolution Health should have made more effort to reach me and should have requested my consent to deduct such a huge amount from my account.
Now I am not going to waste my time with this matter anymore I consider what you did as theft, so I want my money refunded by end of the month or I am going to cancel my membership if this cant be done as I consider a medical aid as high priority and would rather opt to go with a company that is more focused on customer liaison and delivery and effective service.
Membership number: [protected]
Identity number: [protected]