Extremely Disappointed with Discovery’s Claims Department – ***

I am extremely disappointed and frustrated with the ongoing failure by Discovery’s Claims Department to resolve my hospital claims (***). Year after year, Discovery cuts benefits while increasing premiums, yet when we need support the most, we're left to carry the financial burden ourselves.

Despite sending multiple emails and follow-ups, I’ve received no real response. Meanwhile, the hospital continues to bombard me with SMSes demanding payment for claims that Discovery should have covered in full.

Let me be clear: my hospital stay was fully authorized, and Discovery has an agreement to pay 100% of the medical rate to the hospital. That’s what we pay for — peace of mind in times of emergency. Instead, I’ve been left dealing with unpaid bills, constant stress, and financial pressure during a time when I should be recovering.

My situation became even more complex due to unforeseen complications during my procedure, resulting in an extended hospital stay and treatment for sepsis and related conditions. These were not planned or avoidable, and were a direct result of the initial authorized treatment. A supporting medical letter was submitted — still no action.

According to Regulation 8 of the Medical Schemes Act 131 of 1998, medical schemes are required to cover in-hospital PMB treatments in full — with no co-payments or deductions — especially when pre-authorization has been granted. Yet, Discovery continues to ignore its legal and ethical responsibility.

I am sick of the silence, delays, and the ongoing harassment from the hospital for unpaid bills. This matter needs urgent attention and resolution. Discovery — this is not what we pay for. Do what’s right: honor the agreement, follow the law, and settle the outstanding claims.