SAMWUMED is committed to fairness, openness, and transparency. The Scheme also promotes the highest level of professional and ethical behaviour.
Members and Providers can use the following methods of communication to lodge complaints or disputes.
- Visit the walk in centre 08h00 to 17h00 Monday to Friday
- Call the call centre 0860104117 / 0216979000
- Write to the scheme (website/complaints email address) complaints@samwumed.org. The complaint will be dealt with in line with the complaint’s escalation procedure as outlined Rule 19 of the Scheme Rules.
SAMWUMED will acknowledge receipt in writing to the Complainant within 24 hours of receiving the Complaint. The Scheme will process and resolve the matter within 30 days following internal process the Complainant will be notified in writing of the findings.
If the Complainant is still dissatisfied after following the above complaints procedure, he/she may request the Principal Officer to refer the complaint to the Dispute Committee.
If the decision of the Dispute Committee is not acceptable to a Complainant, the Complainant may appeal against the decision to the Council for Medical Schemes in terms of Section 48 of the Medical Schemes Act
If a Complainant chooses not to follow the Dispute Resolution Procedure, but to rather lodge a complaint directly with the Registrar of Medical Schemes, the Scheme will submit all the required information to the Registrar.
Any beneficiary or any person who is aggrieved with the conduct of a medical scheme can submit a complaint. It is however very important to note that a prospective complainant should always first seek to resolve complaints through the complaint’s mechanisms in place at the respective medical scheme before approaching the Council for assistance.
Complaints can be submitted to the CMS by Complaints (086) 673 2466 (fax) by writing to complaints@medicalschemes.co.za or visiting the CMS website www.medicalschemes.com
The CMS governs the medical schemes industry, which means it can facilitate unresolved complaints about your medical scheme. If your complaint is related to any other aspect of the health industry, please follow the links below:
- For complaints against Health Professionals (doctors) – hpcsa.co.za
- For complaints against Private Hospitals – hasa.co.za
- or complaints against Nurses – sanc.co.za
- For complaints against Brokers – faisombud.co.za
