Symphony Health tightens claims procedures
Keikantse Lesemela | Wednesday March 18, 2015 10:00
Speaking during a media briefing on Monday, Symphony Health chief executive officer, Rose Tatedi said although they have recorded a high numbers of clients, the company has been forced to review their underwriting schemes.
“We had a lot of people buying our products and services, but most of these clients were dishonest. We had to pay a lot of money to their medical needs in some instances when they had only one month under our cover, so we had to tighten our underwriting scheme to avoid losses,” she explained.
Under these new developments, a client has to undergo medical examinations as part of the procedure before accessing Symphony Health services.
The waiting period will now be six months before the client can claim any benefit.
Symphony Health scheme entered the Botswana market in May 2013. The medical aid scheme offers both existing and potential medical aid members new generation innovative products and services. Its features of are medical savings account, open membership, age-based premiums and legal cover. Among its products include legal insurance, emergency medical rescue, international travel insurance, BabySym and other services. “We did not have the waiting periods when we started, but due to challenges that we experienced with our clients, we had to make some changes and now the customer can only benefit after six months of joining,” said Tatedi.
Tatedi further noted that they have also decided to review and increase the premiums annually. “This is the first review since we started operating in 2013.
This does not mean that we are going to increase the prices every year. Based on market performance, we will then be able to decide whether we can make changes or leave it as it is,” she explained.
Tatedi added that the premium increase is necessary to ensure that the scheme is able to meet its expenses including claims from both the service providers and members.
By April 2015, they will establish the new legal cover, which allows members to choose their own attorney, funeral cover and roadside assistance.
In January, Symphony introduced new benefit option called Sym-Classique Plus, which offers a P1.2 million-hospitalisation benefit.