Clientele Medical Aid Contact Details

Clientele does not sell a medical aid, and this is the one thing to be clear about before you phone. What it sells is a Hospital Plan — the H.E.L.P Plan — and Clientele prints the statutory warning on its own product page: this is not a medical scheme, the cover is not the same as that of a medical scheme, and the policy is not a substitute for medical scheme membership.

Clientele contact details

• Telephone: 011 320 3000
• WhatsApp: 067 342 7248
• Life and hospital plan service: services@clientele.co.za
• Claims: claims@clientele.co.za. Legal service: legalservices@clientele.co.za
• Address: Clientele Office Park, corner Rivonia and Alon Road, Morningside 2196

Operating hours are Monday to Friday 08:00 to 17:00 and Saturday 08:00 to 12:00. There is also an SMS route for claims: send the policy number to 43973 at standard rates.

What the difference actually means for you

A medical scheme pays the hospital. A hospital plan of this kind pays you a cash amount for each day you are in hospital, and you settle the bill yourself. That is why Clientele’s testimonials talk about using the money for school fees and bills rather than for the account. It is a useful product and a poor substitute: if you are admitted with a large bill and no scheme membership, the cash benefit will not cover it.

• A medical scheme is regulated by the Council for Medical Schemes. A hospital cash plan is an insurance policy regulated as insurance, and the two have different rules and different protections.
• Waiting periods apply. Clientele reduces the 12-month waiting period for a condition by whatever you have already served under similar cover with them or another insurer in the previous 90 days — so tell them about the old policy.
• Cover is per admission and per day, not per rand of the account.

What the claims department needs

• Hospital illness: the original hospital account showing admission and discharge dates, or a discharge summary from a public hospital, and a certified ID copy on the first claim for each insured life.
• Hospital accident or motor vehicle accident: the same, plus the police report completed by the investigating officer, the official road accident report, and a certified copy of the driver’s licence if the claimant was driving.
• Hospital maternity: the hospital account or discharge summary, and a certified copy of the baby’s birth certificate.

Which Clientele business you are dealing with

Clientele Limited is the licensed controlling company of the Clientele Insurance Group, and the group also trades as 1Life and Emerald Life. Life policies are underwritten by Clientele Life Assurance Company. The product range runs across funeral, legal personal and business, health, Royalty, Perks, mobile, wealth plans and investments — and each has its own claims route, so say which plan you hold when you call 011 320 3000.