Legal · Complaints
Complaints Procedure
Effective date: 1 January 2026
ClaimIQ SA (Pty) Ltd takes complaints seriously. This procedure explains how to raise a concern about our service, how quickly we will respond, and how to escalate the matter to the appropriate South African regulator or ombud if you remain unhappy with our response.
1. Lodge a complaint with ClaimIQ first
Wherever possible, please give us the opportunity to resolve your concern directly before escalating. Send your complaint by email tocomplaints@claimiq.co.za and include:
- your full name and contact details;
- your case reference (e.g. CS-XXXXXX) if applicable;
- a short description of what happened, dates, and the outcome you are seeking;
- any supporting documents or correspondence.
2. Our response timelines
We will:
- Acknowledge your complaint in writing within 3 (three) business days of receipt;
- investigate the matter and provide afinal written response within14 (fourteen) business days of receipt;
- if a complaint is unusually complex and requires more time, tell you in writing, explain the reason, and give you a revised response date.
3. Choosing the right escalation route
If you are not satisfied with our final response, you may escalate. The right escalation depends on what the complaint is about:
4. Complaints about ClaimIQ's service (fees, refunds, conduct)
These fall under the Consumer Protection Act 68 of 2008. You may refer them to:
- National Consumer Commission (NCC) —www.thencc.gov.za
- Consumer Goods and Services Ombud (CGSO) —www.cgso.org.za
5. Complaints about the medical scheme's decision
If your concern is with the underlying medical scheme decision (rejection, underpayment, PMB non-payment, benefit interpretation), the correct regulator is the Council for Medical Schemes, which regulates schemes under the Medical Schemes Act 131 of 1998:
- Council for Medical Schemes (CMS) —www.medicalschemes.co.za
- Complaints email: complaints@medicalschemes.co.za
You must ordinarily exhaust the scheme’s internal dispute process first. If you are on an active mandate with us, we will typically lodge the CMS complaint on your behalf.
6. Complaints about how your personal information is handled (POPIA)
If your complaint relates specifically to how ClaimIQ has collected, used, shared or protected your personal or health information, please see ourPOPIA Notice. You may escalate to:
- The Information Regulator of South Africa —inforegulator.org.za
- Complaints email: complaints.IR@inforegulator.org.za
7. Confidentiality and non-retaliation
Complaints are handled confidentially by our internal review team. Raising a complaint will not adversely affect the handling of your active claim(s) or your ability to use our service in future.
8. Contact
ClaimIQ SA (Pty) Ltd
Registration No.: [Pending CIPC Registration]
Complaints: complaints@claimiq.co.za
General support: support@claimiq.co.za