1 reviews | Active since Nov 2022
Discovery Not Paying According to their own schemes.
1. Discovery sent me correspondence for about 6 weeks regarding a PMB form for a medical aid claim. When I enquired about the claim status at the call center, I was told there is not claim registered on their system. 2. After using the Discovery Hospital Network as per my plan, Discovery is declining all my claims relating to a sports injury (included in a Classic Smart). 3. Not my broker, or a claims consultant informed be that a Discovery GP must activate the benefit until about a month after I initiated the original claim. The GP cannot set the date for the injury, even though multiple hospital, specialist and radiology reports all list the same original date. Discovery Claims they cannot change this date according to the existing medical reports. 4. Claims for after the date initiated by the Discovery GP have now been declined. 5. No manager at the call center will take my calls when i phone because "they are too busy"
I just want some help.
Your claims team is now saying that my ER visit (on a Saturday afternoon around 4:30 for a open fracture in a Smart Network Hospital) does not count as a GP visit. I have sent my ER discharge papers, with radiology reports, but apparently the only proof that will be considered is an additional claim for the ER visit, which seems like strange advice as ER cover is not accounted for in my scheme (Classic Smart).
Additionally, when I ask to escalate to a manager, I receive no contact from someone with a higher level of authority.
And lastly, Discovery has app**** an incorrect date to my sport injury and will not correct it, even though I have supp**** clinical documentation supporting the date of injury. I have insisted that I do not accept this date and that my acceptance would be insurance *****.
Please can someone with the correct level of authority and clinical expertise contact me or come see me in person.
Your claims team is now saying that my ER visit (on a Saturday afternoon around 4:30 for a open fracture in a Smart Network Hospital) does not count as a GP visit. I have sent my ER discharge papers, with radiology reports, but apparently the only proof that will be considered is an additional claim for the ER visit, which seems like strange advice as ER cover is not accounted for in my scheme (Classic Smart).
Additionally, when I ask to escalate to a manager, I receive no contact from someone with a higher level of authority.
And lastly, Discovery has app**** an incorrect date to my sport injury and will not correct it, even though I have supp**** clinical documentation supporting the date of injury. I have insisted that I do not accept this date and that my acceptance would be insurance *****.
Please can someone with the correct level of authority and clinical expertise contact me or come see me in person.
I had a medical emergency in September. I submitted a claim for the treatment in September, but the valid dates from your Team reads "December 2022 to March 2023" with no explanations.
You guys actually have not contacted me at all. The only contact I have with Discovery is everything I initiated.
I really, really just need clear communication and help.
Kind Regards
I had a medical emergency in September. I submitted a claim for the treatment in September, but the valid dates from your Team reads "December 2022 to March 2023" with no explanations.
You guys actually have not contacted me at all. The only contact I have with Discovery is everything I initiated.
I really, really just need clear communication and help.
Kind Regards
