Dissapointed Individual - Discovery Health

Whilst i never experienced bad service from Discovery however this leavse no choice because this has left a hole in me .

I am writing to formally lodge a complaint regarding the handling of a medical claim for my mother, Kogilambal Vandayar (Membership No: ***), who was admitted to Lenmed Health Shifa Hospital and underwent a medical procedure on 28 January 2025.

At the time, she was covered under the KeyCare Core Plan, and I was the individual responsible for paying the medical aid premiums. All premiums were paid up until May 2025, when I unfortunately lost my job and had to cancel the medical aid due to financial constraints.

Despite the fact that the hospital stay and procedure occurred while the medical aid was active and premiums were up to date, we have now received a claim notification showing that R100 000 + was not paid by Discovery. Furthermore, the hospital is now harassing my elderly parents for payment of this amount, which is both distressing and unacceptable.

This situation is deeply concerning for the following reasons:

The procedure took place while the medical aid was active and premiums were paid. The KeyCare Core Plan should have covered hospital-related expenses at a designated facility. No clear explanation has been provided for the non-payment of the claim. The hospital is now pursuing my parents for payment, despite the fact that the claim should have been settled by Discovery.