Claim rejected, a Prescribed Minimum Benefit not paid, or a benefit dispute going in circles? Get a professional letter that quotes the Medical Schemes Act and sets a deadline — drafted in under two minutes.
Medical schemes reject claims with standard-form letters that rarely explain the real reason. A written dispute that quotes your scheme rules — and, where it applies, your Prescribed Minimum Benefit entitlement under the Medical Schemes Act — forces the scheme to justify its decision properly. It's also the record the Council for Medical Schemes will expect to see when you escalate.
Describe the claim and why the decision is unfair. You'll get a professional dispute PDF that quotes the Act — for R79, no account needed.
Yes. Your scheme must give reasons and has a formal internal dispute process. Put your dispute in writing, referring to your scheme rules and any PMB entitlement. If unresolved, complain to the Council for Medical Schemes.
A defined set of conditions and emergencies every registered scheme must cover in full, regardless of your plan, subject to designated providers and protocols. If a PMB was refused, your letter can raise it specifically under the Medical Schemes Act.
R79 as a once-off payment — no subscription and no account required.
The Council for Medical Schemes (CMS) regulates schemes and handles member complaints once you've used the internal dispute process. Matters can go further to the CMS appeal structures and the courts.
LetterUp is a document preparation service, not a law firm. Letters drafted on this platform reference applicable South African legislation but do not constitute legal advice and do not create an attorney-client relationship. For complex disputes or legal proceedings, consult a qualified South African attorney.