1 reviews | Active since Sept 2014
Discovery rejected claim: not honouring back-dated addition of baby to policy
I gave birth on 29 February 2020, and added my baby to my policy on Discovery's website on 7 April but it was never activated due to a lack of communication by Discovery due to the lockdown. The only instruction I received during the online application, was to email her birth certificate to *** which I did the very same day. No further feedback or instructions was ever communicated to me after this date. On 5 May, I checked my bank statement and noticed that my Discovery premium at the end of April had not gone up. It should have increased if my baby was added as a dependant on my membership policy. After phoning Discovery on 5 May and speaking to several consultants, the policy was finally rectified. I was shown to do a bunch of extra things on the online application which were not there before and of which I was not notified or reminded after 7 April when I app**** the first time. My baby was then added specifically backdated to 1 March upon my insistence, and I also paid the premiums backdated accordingly. R2190 was added to my normal premium once-off at the end of May, this is for the additional premium of R730 per month for March, April and May. The backdated premiums were paid in full at the end of May - my debit order was R5476 instead of the previous R3286. I am therefore entitled to all benefits from 1 March. I lodged a claim for my baby's 6 week checkup with Dr Bruwer, which I am entitled to. However, it was rejected, at first when the practitioner claimed directly, and then when I resubmitted it, it was rejected again. I am still waiting for the money. Herewith the trail of reference numbers: ***
Online application to add baby to membership – 07/04/2020
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Resubmitted claim for Dr Bruwer’s account (direct claim by the practitioner was rejected) – 03/06/2020
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New reference number after following up on *** – 14/06/2020
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Feedback from Siphokazi Gova that my baby was not covered on treatment date 15 April, stating that she was only added on 5 May – 15/06/2020
I rep**** back with all the details as described above, that my baby's cover was back dated to 1 March. ***
“In order to have the claim fund from Risk the benefit start date needs to be amended. We have referred the query to the relevant department for processing. Please allow two to three working days for feedback.” – 18/06/2020
“The query for Dr Bruwer’s account is still in processing. Please allow a further 2 to 3 working days to provide you with feedback.” – 23/06/2020
“The query for Dr Bruwer’s account is still in processing. We do apologise for the delay in feedback and any inconvenience it has caused. We will provide you with feedback as soon as we are able to correct the activation date on record.” – 06/07/2020
“The query for Dr Bruwer’s account is still in processing. We do apologise for the delay in feedback and any inconvenience it has caused. We will provide you with feedback as soon as we are able to correct the activation date on record.” – 14/07/2020
"We have escalated the matter to our Systems Department for investigation. We are working to resolve your query and assist with reprocessing the affected claims. Please allow for 1-2 working days for an update." - 16/07/2020
"The query for Dr Bruwer’s account is still in processing. We do apologise for the delay in feedback and any inconvenience it has caused. We will provide you with feedback as soon as we are able to correct the activation date on record. - 21/07/2020
As I am sure you can see from the above, I am not getting satisfactory assistance in this regard. It is totally unacceptable to wait this long and be treated this way, for a mere R598.60 claim after I paid R2190 once-off to ensure that my baby is covered from 1 March. It is a simple request and should not be dismissed and delayed as long as it has been to date.
I have escalated this on every possible online platform on Discovery's website and also emailed their Executive Office in KZN, but to no avail.
Discovery Health Servicing Team
Discovery Health Servicing Team
Discovery Health Servicing Team
Discovery Health Servicing Team
