Essential Saver plan ******* - No cover for medical emergency

<p>On Saturday morning, I severely injured my ankle after i rolled it. At the time I left it not being too concerned, however after a few hours my foot had swolen so severely and it went black and blue. Being in KZN for the weekend and knowing that I would have to get back to Jhb on Monday morning for work, I was rushed through to hospital at midnight. The casualty doctors were concerned, and immediately sent me for X-rays as it did not look good. The X-rays came back with no fractures, however ligament damage was the main concern. The hospital did not have a radiologist that could perform the sonar, they advised that i should return the next morning (being a few hours later as it was already 1am in the morning), so that they can fit a moonboot to reduce the swelling in the interim until they could do the sonar. Returned to hospital a few hours later (why i was not admitted is beyond me as the doctor on call advised me that it was severe tissue damage and i could have been placed on a drip to reduce swelling). Long story short, they fitted the moonboot but they were unable to do the sonar. I am now having to wait for a sonar at a different facility this afternoon to determine the extent of ligament damage. So before i even know whether or not they need to operate, i contacted Discovery for authorisation on the Sonar. Spoke to Nandipha, and Nompulelo and was advised that Discovery will not cover ANY of the expenses incurred thus far for my medical emergency as it comes out of my day to day cover, and i was not admitted. Firstly, i could have been admitted and in fact probably should have been admitted to be placed on a drip on Saturday morning at 1am. It was a waste having to return the next morning to have a moonboot fitted and that a sonar could not be done due to lack of staff being able to do so. Had it not been a medical EMERGENCY i would not have gone to hospital at 1am in the morning to have it sorted out. How does Discovery justify decling covering a client who has not once claimed in the past 12 months but nearly pays R2100 a month for something that is nothing more than a glorified hospital plan? I will be escalating this to the CMS, the public protector and whoever else should be deemed relevant to investigate the merits of this matter, as not even the Manager in the authorisations department could assist me with actually justifying WHY Discovery would not cover ANY of my expenses. This is complete unjustified enrichment on Discoveries part. I am stuck in Kwazulu Natal being unable to even return to work in Johannesburg due to the severity of my injury, and Discovery deems it acceptable to advise that this, according to them, does not warrant cover. Had it not been a serious and severe injury, i would have easily returned to my normal day to day life. </p>