Actively Avoiding Claim Settlement
<p>I was told by your call centre agent to send my complaint email to ********** My email was rejected with a message that this mailbox does not exist. Surprise surprise. Anyway, heres my complaint again:</p> <p> </p> <p>Hi,</p> <p>I would like to find out what your customer SLA is with regard to handling of claims.</p> <p>Please observe claim reference ********** 106</p> <p>I submitted this claim last Tuesday ****h July) and upon querying this claim with your call centre this morning, I have been told I need to wait up to another 72 hours. Note that nothing was happening until I called in.</p> <p>This is unacceptable. What is your SLA?? The last claim I submitted was also ignored completely because the attachment was "*******ed" on your side and you guys would have done nothing until I phoned to query the claim.</p> <p>Are you actively finding ways to avoid settling claims? This sets a very bad PR precedent for your scheme. I am tempted to initiate a social media study to gather and consolidate similar complaints and determine if this a pattern on Discovery's side or not, in which case you will be exposed.</p> <p>Regards,</p> <p>Damian Burnett</p>
Dear damian-burnett
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.
Regards
Discovery Health Servicing Team
Dear damian-burnett
We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.
Regards
Discovery Health Servicing Team
Dear damian-burnett
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team
Dear damian-burnett
We have been in touch with you to answer your comments.
Regards
Discovery Health Servicing Team
For the benefit of other members, the feedback was as follows:
- SLA for claim processing is 3 working days (this is internal processing, and does not impact the payment date for when the claim payment is made)
- After claim processing, customer can wait up to 3 additional working days for the payment to be processed. This differs from the feedback of the previous consultant I dealt with who explained that payments are made once a week, typically on a Thursday. The fact that payment is being released to me today means that it is not always on a Thursday, so I guess we shall have to see with future claims.
- The claim consultants are presently not allowed to email customers directly, which means that should a claim submission have an error, such as the email attachment being rejected by the Discovery email server, then this will simply be ignored and the onus is on the customer to chase up. The consultant I spoke to today mentioned that they might look at a way to implement a system which would allow customers to be notified of such failures.
I am going to keep a close eye on my future claims, in terms of processing and payment timelines and I will be sure to identify any breach of SLA and raise this in a public forum. Customers should NOT have to chase up claims repeatedly due to Discovery operational issues. I was politely informed by the consultant today that Discovery deals with tens of thousands of claims - guys this is NOT a burden you should be complaining about. Each of those customers pays several thousand rand a month to Discovery, which most certainly has the administration costs built in, with fat.
For the benefit of other members, the feedback was as follows:
- SLA for claim processing is 3 working days (this is internal processing, and does not impact the payment date for when the claim payment is made)
- After claim processing, customer can wait up to 3 additional working days for the payment to be processed. This differs from the feedback of the previous consultant I dealt with who explained that payments are made once a week, typically on a Thursday. The fact that payment is being released to me today means that it is not always on a Thursday, so I guess we shall have to see with future claims.
- The claim consultants are presently not allowed to email customers directly, which means that should a claim submission have an error, such as the email attachment being rejected by the Discovery email server, then this will simply be ignored and the onus is on the customer to chase up. The consultant I spoke to today mentioned that they might look at a way to implement a system which would allow customers to be notified of such failures.
I am going to keep a close eye on my future claims, in terms of processing and payment timelines and I will be sure to identify any breach of SLA and raise this in a public forum. Customers should NOT have to chase up claims repeatedly due to Discovery operational issues. I was politely informed by the consultant today that Discovery deals with tens of thousands of claims - guys this is NOT a burden you should be complaining about. Each of those customers pays several thousand rand a month to Discovery, which most certainly has the administration costs built in, with fat.