Frequently Asked Questions: Complaints Against Schemes

Where do I complain if claims are not paid timeously or when I am dissatisfied with a   decision taken by the Scheme?} Any complaint must first be lodged with the scheme concerned. All schemes should have dedicated telephone lines to handle everyday complaints and enquiries, however written complaints are preferable so you as the member have written proof. All schemes are also required to have independent disputes committees where members' disputes may be settled. Members and or their legal representatives may be present at disputes committee meetings to present their arguments. Should all efforts fail to resolve an issue with your scheme, you can submit your complaint to the Council for medical Schemes Complaints Unit by either posting, faxing, emailing or submit online by going to the following website address: