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Question
Posted by: lovers | 2005/07/05

Fraud on the medical scheme.

I'm using Sizwe medicai Aid my problem is i cancelled my ex from the medical only my children are covered,but she still go to doctor with the old medical aid for treatment/test and the medical scheme does not pay as she is not covered so all the statement comes to me, the pathologist is even trying to sue me they say the medical belong to me. What must i do about this issue i even tryed to give pathologist her/ex contact numbers and adress so that they must send her the bills and communicate with her.

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Our expert says:
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There is not much that your medical scheme can do regarding this. I suggest you speak to your attorney.

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Our users say:
Posted by: Keen | 2005/07/08

Well, as she is not oficially on your medical aid anymore, they cannot make you responsible for the bills. She committed fraud and the pathologist must take it up with your ex. Ask your m/aid to fax you a letter stating what her membership period was on your sccheme. Fax this to the pathologist then as proof that she is not on your m/aid anymore and that you are not responsible for the account. Has got nothing to do with you. Go see a lawer to writer a letter to her if you feel it will help. Otherwise call her and tell her NOT to use your medical aid anymore.

P.S. Just make sure that she was not a dependant on your m/aid after you guys split up...sometimes people don't cancel the dependants when these things happen and the member ends up with the mess.

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