12 month waiting period imposed for normal eyes!!!!

I have been in the process of applying for Medical Aid with Discovery for a couple of weeks now. And sadly, still living without Medical Aid cover.

On my application form that I submitted, I disclosed that I have (among others) had consulted a GP in August this year and they detected a heart murmur and referred me to a cardiologist (I never went to see the cardiologist before applying for Discovery Medical Aid), I also disclosed that I have been seeing floaters (random dots) from the beginning of this year (of which I still see), I have never consulted any doctor/specialist nor sought any medical advice for seeing floaters as they never bothered me.

My broker then told me the 'underwriters' require that I get a special heart report completed and that I get a diagnosis for the floaters I see.

I went to see a cardiologist and an optometrist, both of which said my heart and eyes are normal. I sent both reports stating that I have a normal heart and eyes to my broker/underwriters.

To my surprise, my broker sent me an offer letter imposing a 12 months waiting period for: 1. Disorder of the globe 2. Visual disturbances

I called Discovery to find out about this and spoke to a Siphokazi from underwriters who tried to explain that the waiting periods would only be app**** for claims that are from conditions caused by the fact that I see floaters (that sounded fair enough) and said they would send me a detailed report explaining what the waiting periods apply to, and not apply to, on the same day, I sent my broker an email saying I do not understand why those waiting periods have been imposed as both doctors I saw said both my eyes and heart are normal.

Come Monday, the 3rd of December. The day I expect the underwriters to provide me with a letter that explains exactly what conditions the two twelve-month waiting periods apply to and not apply to. What do I get? A revised offer letter where they removed the waiting period on 'Disorder of the globe' but still with the 'Visual disturbances' with the message below: The underwriters have reassessed the original terms offered and had agreed to remove the Disorders of the globe waiting period – the only one remaining is the Visual disturbances and that is because the member still sees the “floaters”. “The underwriters didn’t feel that any heart-related waiting periods needed to be placed however the eye waiting period will need to remain”

I expressed to my broker how disappointed I was that he was sending me a revised offer letter instead of what I asked for: an explanation of what exactly those waiting periods meant (i.e. what conditions would they apply to and not apply to). I asked that he please ask them to send me what I asked for.

My broker then sent me the message below from the 'underwriters' today: “The member stated she was seeing “floaters” in her vision/ eyes. She then went to the eye specialist for this – because the member sought treatment / medical advice related to this, we are allowed to underwrite for it and place an applicable waiting period. We do not have a waiting period specifically for ‘floaters’, however this would fall under the category being ‘visual disturbances’. The waiting period imposed, if accepted, will exclude cover any claims that are related to any consultation/ treatment and medication for any type of visual disturbance for the first 12 months of membership.”

Now the statement above is not accurate when it says I saw floaters, then went to see a specialist for this. I never saw a specialist, nor doctor, nor sought treatment / medical advice related to this before. I only ever saw an optometrist on 22 November because I was instructed to do so to get a diagnosis by the underwriters. I disclosed the 'condition' under health conditions I have never sought medical advice/treatment for.

The following statement is not at all fair: “The waiting period imposed, if accepted, will exclude cover any claims that are related to any consultation/ treatment and medication for any type of visual disturbance for the first 12 months of membership.” Goodness me, I do not have a problem with Discovery saying they will not cover any consultation/ treatment and medication for any condition I get as a result of seeing floaters, but them saying they will not cover any consultation/ treatment and medication for ANY TYPE of visual disturbance for the first 12 months of membership is simply unfair and unwarranted considering the fact that I have normal eyes.

I need to get medical aid cover asap, it's been already one month that I have been uncovered. Please help sort this thing out and come up with a fair offer letter that I can accept!