Discovery communication failures, dishonesty and incompetence

In April I was admitted to hospital due to a potential blood clot. This admittance was done under the instruction of my GP and I was going to be admitted by the physician at the hospital. We received authorisation from Discovery for this admittance, and I was admitted to our network hospital.

On the night I was admitted, there were no specialists on call. The physician requested multiple blood tests to be conducted, all of which Discovery approved. When my husband inquired about the tests and scans, the physician stated: 'If your wife has a blood clot in her lungs, she might die. These tests will show if she does'.'

It seems appropriate to reiterate that the physician called for the tests, due to the emergency of the situation. There was no specialist on call. Discovery authorised all tests and blood work.

Shortly after I was discharged, I began to receive multiple invoices from PathCare as well as the physiothe****** who had assisted. I began querying all of these with Discovery. It should be noted here that multiple emails were sent to Discovery that were unanswered. We were forced to inquire about these outstanding invoices telephonically. All requests for decisions in writing have were not followed through by Discovery, so there currently is not a paper trail - despite our multiple requests for this.

After multiple conversations with Discovery, Discovery finally agreed to speak to the physician about the tests that were ordered without a specialist on call. Again, multiple telephone calls were required as Discovery made no effort to follow up or uphold their end of the contract. All of these calls were done through the Discovery app, and so Discovery should have records of these call logs, including reference numbers.

After Discovery received information from the physician in early August, the agent I spoke to stated that - considering the circumstances of the hospitalisation - the amount would be paid through the scheme, and was being processed. I was told it would take 5-7 working days for it to be processed. PathCare continued to send invoices, and once again we were required to follow up telephonically with Discovery. We were told that the payment was still being processed. We were told that it would be escalated, but the payment had been accepted.

Once again, I followed up with Discovery, and we were told that the payment was not paid due to a system error. Again, we were told it would be escalated. The same thing was said to us earlier this month. All the while we are receiving invoices from PathCare and lawyers letters and phonecalls. Again, system error was blamed, and 2-3 working days (meaning it should have been paid by mid-October).

Then I started receiving phonecalls from the lawyers for PathCare. We then involved our broker to follow up on this matter. This repeated on the following day. We received further calls from lawyers, so further follow ups with our broker, and then we received a phone call (not an email) from Discovery.

On this phonecall, despite what we had been told previously, we were told that Discovery would not be paying from the scheme. This is in contradiction to everything that they have told us over the past few months.

I am requesting this urgently to be escalated, as we are now in a legal liability due to Discovery's utter incompetence, dishonesty, and seemingly weaponised incompetence.