Discovery declines medically necessary procedure over 0.5cm – shocking service

I am extremely disappointed with Discovery Health and the way my case has been handled. I have a painful epidermoid cyst on my right shoulder that affects my daily movement and sleep. After following their exact process, submitting all requested documents, and even paying for additional consultations out of my own pocket, my request was declined. The reason? My lesion is approximately 1.5cm instead of 2cm — meaning I “missed the criteria” by 0.5cm. What is most frustrating is:

I was initially told one reason for the decline, then later given completely different reasons Additional criteria were introduced after my submission I had to follow up multiple times with no response Turnaround times were inconsistent (3–5 days became 8 days, then suddenly less than 24 hours) I had to repeat my case to multiple agents I even experienced unprofessional behaviour from an agent during a call

I am in daily pain and paying for private healthcare, yet I am being denied assistance over what is essentially a technicality with no flexibility or medical consideration. I have now requested a full written breakdown of their criteria and how I supposedly do not meet it, and will be escalating this to the Ombudsman. This experience has shown a complete lack of transparency, consistency, and care for members.