Unfortunately there are instances when administration errors arise and medical aid members have to bear the brunt for incompetence on the part of medical aid members or even otherwise simple mistakes. However, there are probably very few errors that can be as upsetting as being told that you have died and are therefore no longer part of the medical aid. It happens even in this day and age (2012) and it can be one of the most frustrating errors to have to correct. Not only does it end up being an inconvenience to the alive and well medical aid member, it can also put or her in a severely compromising financial position should medical bills not be paid to providers.
How can medical aids make a mistake about death?
There are countless ways in which such errors can arise but an efficient medical aid with competent staff will usually have several checks in place to ensure that such mistakes never occur. Medical aid numbers may be confused, member’s names may be similar or sometimes and incompetent medical aid employee may just not be paying attention to their actions on the scheme’s database. It is rare but it does occur. Whatever the case, the focus should rather be on the fact that this has occurred rather than identifying the culprit and trying to get a reason from such a person.
Ultimately the medical aid as a whole is responsible for these errors and need to be lambasted, rather than trying to pinpoint an individual. However, let us not forget that errors with government departments submitting wrong death certificates may sometimes be to blame but then question arises as to who handed in this death certificate to the medical aid and had authority to state that you are deceased.
Undo Deceased Status on Medical Aid
As frustrating as it is, the ‘deceased’ medical aid member now has to prove that he or she is truly alive. This can be easily achieved with an affidavit and supporting documents like your green bar coded South African identity document or passport. By appearing before a Commissioner of Oaths who can then verify your identity with your ID book or passport, your affidavit should hold sufficient weight for your medical aid to reverse their error. Even once this deceased status is removed from the system, there may be some implications for the period during which you were thought to be dead.
It is likely that once you were marked as deceased then your medical aid cover may have ended and the scheme was no longer deducting your monthly contributions from your account. Claiming ignorance about the fact that you were not being billed for your medical aid will not hold water later on. If this was the case, you will need to pay the scheme for the missing contributions during the period you were considered ‘dead’. Furthermore, the medical aid may put all medical bills incurred during this time on hold until you ensure that you are fully paid up.
Legal Recourse for Dead Status on Medical Aid
Fortunately we live in a democratic country with a number of regulatory bodies monitoring all sectors of industry. Medical aids are not immune to the law of the land, even government schemes. You have recourse if you have been severely compromised by an error on the part of the medical aid that rendered you with a ‘deceased status’. Ranting and raving on HelloPeter.com may provide some stress relief but may not necessary resolve the issue. You should immediately seek the advice of a private attorney where possible and speak to the Council for Medical Schemes.
The Council is the regulatory body for all medical aids that not only allows them to operate in South Africa as a medical aid but will also take decisive action against schemes that break their rules and disadvantages medical aid members in some way or the other. It is important to note that the Council for Medical Schemes and your medical aid are two different entities so lambasting the Council’s staff will be of little use. Rather state your case in writing and fax, post or email the Council clearly outlining the events that transpired in a chronological manner. Although your deceased status may be removed from the medical aid’s computer system, it is important for the Council to be aware that some schemes do not have backup checks in place.