CM
Clvie M

1 reviews | Active since Dec 2021

07 Aug 2025, 09:12

Discovery Abandons Injured Teen – No Response Weeks After Legitimate Appeal

On 2025/06/25, Discovery Health refused to cover emergency treatment for my teenage son’s dislocated shoulder, citing an alleged “pre-existing condition.” This was not based on a diagnosis, but on vague and outdated notes — and completely ignores the fact that he had never experienced a dislocation before.

We submitted a formal appeal on 2025/06/26, supported by medical documentation and a detailed explanation. We followed up with Discovery on 2025/07/01 escalated to the executive office again on 2025/07/21 — and to date (2025/08/07), we have received no response, no update, and no acknowledgment.

This complete radio silence has left our family without medical aid coverage — during a time when our son is still in pain and needs follow-up care. Discovery’s inaction is not just frustrating — it’s dangerously irresponsible.

This is now more than just a bad call — it’s systemic failure to handle legitimate claims and appeals with urgency. I have since escalated the matter to the Council for Medical Schemes (CMS) and will pursue every public and legal route to hold Discovery accountable.

This level of disregard for patient welfare — especially involving a child — is shameful and should concern every member of their scheme.

0
Replies (5)
Discovery Health
Discovery Health's reply07 Aug 2025, 10:06
Official
Dear Clvie M
 
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
CM
Clvie M's update08 Aug 2025, 11:20
Reviewer Update
Please can I get feedback?
Discovery Health
Discovery Health's reply11 Aug 2025, 12:58
Official
Dear Clvie M
 
Please check your emails for feedback from us.
 
Regards 
Discovery Health Servicing Team
CM
Clvie M's update16 Sept 2025, 08:53
Reviewer Update
I submitted an appeal to Discovery after they cancelled my membership, claiming non-disclosure on my son’s shoulder injury.
On 8 August 2025, Discovery confirmed in writing that they would follow up with the doctor on 12 August 2025 and then finalize the appeal.
Since then, I have heard nothing back. Instead of giving me an outcome, Discovery simply refunded my contributions. That is not what I asked for — I wanted the appeal properly considered so that my family, and especially my son who is still in pain, could have cover.
Right now, we are left without medical aid and no clear answer.
It is unacceptable that Discovery set timelines and then ignored them.
All I want is closure and a fair decision on the appeal, so I know what steps to take next.
Discovery Health
Discovery Health's reply19 Sept 2025, 16:43
Official
Dear Clvie M
 
Please check your emails for feedback from us.
 
Regards 
Discovery Health Servicing Team