According to the Scheme rules, members can lodge a complaint with the Scheme in the following ways:

When you lodge a complaint, the Scheme will respond within five working days from when the complaint was received. There are, however, complaints that need clinical input and investigation and these would reasonably take longer to resolve. A member will always be informed of the status of his or her complaint and the Scheme will work tirelessly to make sure that the complaint is resolved quickly and efficiently.

The Disputes Committee

Should you not be satisfied with the response from the Scheme, you can request in writing that your complaint be lodged with the Scheme`s Disputes Committee (you can send your request to the same contact details listed above). The Committee comprises independent professionals who have medical and legal expertise.

If you are not satisfied with the outcome of the Disputes Committee's ruling, you can lodge a complaint with the Registrar for Medical Schemes for a ruling. You are encouraged to make use of the internal procedures available to lodge your complaints, as you are guaranteed a speedy resolution.