bB
blvanzyl B

1 reviews | Active since Jun 2016

02 Jun 2016, 05:59

Beware of discovery medical aid

<p>Good day. A friend of mine told me about this site. Last year I thought it was time to get medical aid. I was covered since November 2015. Attached you can see me doing very intense exercises without any obvious pain. In the beginning of this year I started to get heavy pain in my shoulder. I only had a hospital plan with gap cover. So I went to a shoulder doctor! He did an ultrasound on my shoulder and couldn't find anything. He then said I must go for a mri scan, so I did. Only then we could see a tear in my ac joint. He said I must go in for a very small procedure. I told him I had a little pain a year ago for a week but it was nothing major, because he asked me if I had any previous injuries. I said no, but just recall that little pain I had for a week for what it was worth. Somehow he mentioned it in letter he had to fill in and then the medical aid twisted the whole thing out of proportion and said I had severe pain now for the last year and I did not declare it. It is far from the truth it's not even funny. They told me they will not pay for the procedure and they will ban me forever from discovery. They even called me and said they spoke to the doctor and he said I had some previous procedures done on my shoulder. They only did that to kind of see what my reactions were. They were lying blatantly to me. I phoned the reception immediately about thisand theyalso sadiscover y is lyislying, they never phoned the doctor because he was that day in theater. I have so much prove that I was 100%fit when I joined them. They are just telling me they are canceling my membership because I had pain in my shoulder before I joined. They don't have any prove or nothing, they just say it. My hands are tied now and I can't leave it, because I know for a fact they are taking chances and are ********* regarding this. I am still shocked by what happened. Anyway now the pain is so bad I can't do my daily routine and it is so difficult to get my work done for the day. Please give me some advise on this. I would really appreciate it. Like I said attached is the photo of me with the date in December with no pain and the letter from the doctor stating that I had the pain recently. This big companies think they can come away with ******, which is so sad. They don't feel nothing for you, except to join them and get your monthly debit order. Thanks for reading my letter. Best regards, Bernard </p>

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Replies (1)
Discovery Health
Discovery Health's reply02 Jun 2016, 10:14
Official

Hi Bernard

Thanks for sharing your concerns with us.

When a member joins the Scheme, we process the application according to the information disclosed on the application. Once your membership is activated and we receive a request for either in or out of hospital authorisation within a certain period of time our system will automatically pend the request. We will then request further clinical information from your provider. This process is necessary to ascertain whether there were any pre-existing conditions of which we were not aware.

I confirmed that the Non-Disclosure Team has been in contact to discuss the details of their findings. You may contact them directly should you need any further information.

Regards

Norman