Discovery pays under 40% of c-section claim

I recently gave birth via c section and after submitting the invoice to Discovery they paid back a measly 37% of our claim. The invoice was over R23 000. When I pre authorized my birth, nowhere did Discovery disclose that they cover so little for this surgery. This is something they should have told us before hand. We pay so much for medical aid so that we are covered but we are still not covered and have to cover the remaining costs out of our pockets. Information such as this should be disclosed before hand. What am I paying medical aid for if the cover percentage is so low?

What I also don't understand is that a friend of mine is on a lower Discovery plan than me. She had a c section at the same time that I did and they paid her a lot more towards it. How does this make any sense? When I phoned Discovery to find out the amount that they pay towards a c section, no one could tell me. Does this mean that they decide what to pay individuals based on how they are feeling on the day because this is what it seems like. Surely there should be a standard rate that Discovery pays for every procedure depending on the plan you are on?

I feel as though there are no standards and Discovery looks for every excuse not to pay members. They do the same for the small claims I submit when they "accidently" pay me from my savings instead of from the scheme. If people don't check the admin side of things, Discovery seems to conveniently pay for claims incorrectly by "accident".

Very sad that a company that should be there to look after you, is doing the complete opposite.