**************** by Discovery Health Medical Aid.

Discovery has captured a lot of market share, and wow are they using this position to stick it to consumers. Give it a try, you will soon see that customer service and the client experience are last on the list of their concerns. Don't get me wrong they were one of the most innovative companies in the sector (5 years ago) but now it’s all about using that position of dominance to drive undue profits at your expense. But don’t take it too personally. When Discovery stick it to you always remember that in their eyes you are a policy and not a person.

Recently I tried to add my spouse (also a Discovery Health member) onto my medical aid. She started a new job and her employer insisted that she join their medical aid scheme (this is also a questionable practice in my view but not the point of this post). She wanted to stay with Discovery, in hindsight I she would have moved!

The Discovery Medical Aid Saving Benefits: you have a specified amount of savings that are consumed through the year as you claim. You pay for these savings monthly with your premiums, but the entire savings amount is available from day 1 of the policy year. Importantly once the savings are used up you pay from your own pocket. If you leave the scheme before the end of the year, Discovery looks at what you have claimed and then they calculate the portion of the annual saving amount you are entitled too.

Example if you have annual savings of 10,000 and you have claimed 6,000. You exit the scheme after 6 months (half the year). Discovery then calculate the proportion of savings you are entitled to (have paid for) as 5,000 (10,000 times 6 divided by 12). Therefore you claimed 6,000 and have savings of 5,000 and you owe them 1,000. In this part of the example, you are terminating your relationship with Discovery so fair enough, you need to pay up.

But what if you are cancelling your individual Discovery policy and moving to another Discovery members policy? I checked this with Discovery and they assured me that the amount claimed less the savings the member was entitled to would be offset from the savings amount of my policy (updated with the inclusion of my spouse).

This statement above is straight forward, logical I would say... but to get to this logical conclusion the customer service department first treated of me like an idiot, arguing with me and rebutting any logical statement with this is our policy. Only when I got firm, and countered every illogical argument they put forward, did the customer "service" officer agree to have a senior person call me back. When the senior Discovery person called - they stated that my spouse would be added to my policy / the new policy (Discovery will say technically there is no combined / new policy and that it is my existing policy, but this does not matter) and no amounts would be payable in cash to discovery. Great a lot of work but all sorted...

No not really, now Discovery dispute this.

In a dramatic 180 degree turn detailed in n a very nice email (where I again felt the warm embrace of being treated like a policy) Discovery said sorry that you received the wrong information, but please pay up.

I would been slightly more understanding (not really as this practice Discovery are implementing is a total ******* - see later paragraphs), if the information that we would not be charged came from thin air or a delightful dream. But the information and confirmation that any amounts owing under my spouses plan would be set off against our combined new policy came from Discovery in the first place (the horse’s mouth). We based our decision to move her to my policy on this information.

Here is a practical example of how Discovery is ripping us off. Let’s stick with the example above but assume instead of leaving discovery, the individual moves from her discovery policy to her spouses after 6 months. Let’s call the spouse “Trudy” (sorry Discovery I should have used a policy number).

Example continued: the shortfall demanded by discovery was 1,000 and Trudy pays this. She migrates to her spouses Discovery policy (let’s call Trudy’s spouse “Jake” – again my apology Discovery). For the rest of the year Trudy and Jake contribute to their medical savings account but never claim. Let’s assume that they both were entitled to 10,000 in savings (as individuals) and 20,000 under the "combined" policy.

At the end of the year they have claimed 6,000, which should be offset against the savings account. But because Discovery performed a mid-year calculation when Trudy migrated they are out of pocket by 1,000...even thought they have 15,000 of available savings (20,000 less the 6,000 claimed, plus the 1,000 demanded back as a mid-year short fall from discovery). If Trudy never moved policies, Discovery would never have asked for the 1,000 payment.

What does this example highlight? Discovery has received all of the monthly contributions so the savings account is fully paid up by Trudy and Jake. But Discovery also sneaked an additional 1,000! So in effect the Trudy and Jake are paying twice for the same thing. They have serviced the monthly contributions and therefore the savings account, but they paid Discovery an additional 1,000.

This is a second bite of the cherry so to speak. No matter what any Discovery policy/practice says this is blatantly wrong, immoral and deplorable.

I cannot wait for the regulatory landscape to change and sort this type of corporate malfeasance out!

I hope this informs you all!