Life Insurance & Medical Aid Disputes
When a life insurance, disability, critical illness, loss of income or medical aid claim is wrongly declined or when essential treatment is refused by the medical scheme, the consequences can be devastating.
We focus on the kind of claims that affect your ability to work, support your family or access life-saving care.
From death, disability, income protection, critical illness and prescribed minimum benefit disputes to major medical aid decisions, we assess whether the insurer or scheme has treated you fairly and advise on the ideal course of action in lodging a dispute.
We address claims challenges and disputes in the following areas:
life insurance: death, disability, income protection, critical illness, impairment and retrenchment benefits;
health insurance: prescribed minimum benefit refusals and major or essential treatment decisions.
Case analysis
coverage (what the policy promises);
evidence (what the relevant documents and medical records show) – and;
fairness (whether the decision was reasonable in the circumstances).
We then help you pursue the appropriate next step.
If you have suffered damages / loss due to medical negligence, if your insurance claim has been wrongly declined, or if you need a qualified mediator for a complex healthcare dispute, we’re here to help.