WF
Will F

1 reviews | Active since Mar 2016

04 Mar 2016, 15:46

Discovery Medical Aid leaves you exposed

On or about December 2015, I approached Discovery Medical Aid, interested in switching my medical cover to them. When the consultant contacted me, I advised that I am a type 1 diabetic and wanted to know if I would be subjected to a waiting period if I switch, because if that is the case, then I am not interested. They explained that I would have to complete a application form and only then will they be able advise on cover. I completed an online application, of which you never receive a copy, where my diabetes was disclosed. Me and my wife was accepted without any waiting periods. On application for chronic medication, I was informed that apparently I never disclosed that I was diabetic. Almost 2 weeks later I receive a call advising that there was an alleged misrepresentation and that cover will be declined. I confirmed that I would dispute same and requested that a copy of application be sent to me. Despite the latter, my cover was cancelled, without receiving any repudiation letter or dispute documents. Thus leaving myself and my wife uncovered over a weekend where one would not be able to dispute such outcome. I find this conduct very ********* and unprofessional.

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Replies (1)
Discovery Health
Discovery Health's reply05 Mar 2016, 16:13
Official
Hello WFritz,

Thank you for your comment.

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.

The Standards team has investigated the details of your application and provided feedback on the findings. You are welcome to contact them should you wish to discuss the matter further.

Regards
Rishana