OM
Ornet M

1 reviews | Active since Sept 2017

16 May 2019, 15:56

Discovery Please Pay Back The Money.

Hello Peter should introduce a no STAR rating, Discovery deserves 0 stars.

This is my second complaint relating to a partially resolved issue raised few days ago.

My policy states that for Emergencies I am covered in full. Well I have been a Discovery's loyal client since 2016. I have never used the Emergency services since 2016, only last month 14th of April. My 2 year old son had very high temperature and could not stop crying, I had to take him to the EU in Life Fourways hospital(this is in the policy smart network) at 3 a.m.

Discovery rejected the claim, however after complaining here on hello peter they came back to me and asked me to fill some forms and afterwards they agreed to pay. The issue now is they only approved to pay the amount charged by the hospital but refuse to pay the money i spent at Clicks for the prescriptions as prescribed by the DR from the EU.

So i need below to be addressed by discovery.

1. I need discovery to explain to me why has the prescription claim rejected? 2. In the event of Emergency what should i do to avoid this in the future? 3. Do you want clients to ask for authorization even for emergencies? - Even though the policy simply states that in the event of emergency one should go to any private hospital. 4. Why is the policy being violated in this manner and what step should i take?

0
Replies (3)
Discovery Health
Discovery Health's reply16 May 2019, 16:02
Official
Dear ornet-mathebula

Your concerns are important to us. We will contact you as soon as possible to answer your comments. 

Kind regards 
Discovery Health Servicing Team 


Discovery Health
Discovery Health's reply20 May 2019, 12:54
Official
Dear ornet-mathebula
We have been in touch with you to answer your comments.

Kind regards 
Discovery Health Servicing Team 
OM
Ornet M's update20 May 2019, 12:59
Reviewer Update
Don't lie, I hanged up as soon as you started talking nonsense. I am filling the CMS complaints forms. We will meet again....