From Wonderful with MSO to Horrible with Discovery to Unresolved with International Travel benefit.

From Wonderful with MSO to Horrible with Discovery to Unresolved with International Travel benefit.

The short of it is that we had to bring someone to ER mid-trip whilst overseas with a fractured heel over a month ago. MSO, who is first point of contact for Discovery Health International Travel benefit, handled it so well over WhatsApp and email whilst at the ER (we didn't even have to pay to be seen) and assuring us Discovery would cover the upgrade to business class to put the leg up to reduce swelling; we had to buy on credit and would be reimbursed later. Upon return to SA, Discovery covered the surgery. We were so happy to have all that support . . . until it came time for Discovery to pay up. The overseas hospital has yet to be paid. The business class upgrade was 3000 euros! Still unreimbursed a month later; and credit card payment went off today. We are disappointed to say the least.

Here's a longer version:

Overseas communication with MSO, who handle the international travel benefit, was amazing. If it were an AI chatbot, it was a really good one. However, it felt like humans: there were two that had different shifts. Of course they immediately asked what happened: I was hesitant to tell them it was a rock climbing accident; yet that was the truth. They said it's covered. Whew. They even texted back to check up on my wife. More than once! When the flight upgrade idea was broached, and the Fit to Fly was issued by the ER doctor, they said "yes, we'll cover it"; even when the price shifted upwards (from 2 to 3 thousand euros!), they texted back yes. We couldn't believe it. The communication over WhatsApp was so easy and convenient. We felt so well taken care of.

We came back home and saw the orthopod the following morning. Scheduled for surgery the following week. It really was stressful: dealing with the injury whilst overseas, 3 flights home (which went really well, btw), in for surgery . . . all the paperwork for the insurance, the flight, me dealing with work, her with missing work and not being able to put weight on the foot . . . The surgery was successful; likely very much due to the swelling having gone down with the quick diagnosis of fracture with x-ray and CT scan at the overseas ER, the flight upgrade (for her only! come on!), the airport wheelchairs, etc.

A week or so after return, we submitted all required paperwork, forms and invoices/receipts, to claims@discovery on 23 Oct. And then it all started to go downhill fast.

Firstly, we found out that the hospital overseas had not been paid. How? They emailed us. We had assumed MSO/Discovery had taken care of it because MSO and the hospital had emailed one another their respective forms whilst we were in the queue and triage. Nope. And we were told by Discovery to pay the 100 euro deductible directly the hospital. We asked MSO and then Discovery (because MSO doesn't get involved with payments) to please pay the full 300 euro hospital bill and let us pay them back the deductible locally; and Discovery said no. We pay the hospital 100 and they will pay 200. We were in the ER 8 Oct. It's 15 Nov. Discovery still hasn't paid them yet.

Secondly, on 24 Oct, the day after we first submitted the documentation, Discovery asked for the flight upgrade tickets and invoices. Huh? These had already been sent the day before. We resent them. 7-10 working days they said. And again. And again. Two weeks later, on a Friday, a small payment of about R1000 was made into my bank account, with no email telling us what it was for. We guessed it was for the prescribed hospital pain meds and crutches that was on the claim form along with the roughly R58000 for the flight upgrade. After the weekend, on Monday, we finally got the email/pdf confirming that yes, it was about R3000 claim less the 100 euros deductible (2nd deductible) for hospital expenses. Let's be clear here: the airfare upgrade item was on the *same claim form* originally submitted on 23 Oct.

We had called about every 2nd or 3rd day or so to follow up since submission. Over a span of 3 weeks, we were asked to resubmit the upgrade tickets/invoices *a total of 4 times* and a full week after that partial payment less deductible, we finally were told by Discovery that the upgrade reimbur*****t line item was up for review because the necessary paperwork was not submitted. Come on! We submitted it 4 times!

We filed a complaint with Discovery. How could they process the pain meds and crutches reimbur*****t and not the upgrade when all of the documents were submitted together in a single zip twice, and the tickets on their own separately two more times?

Thirdly, it felt like every single call with Discovery was dropped mid-conversation. And even when they called us back after a dropped call, e.g. 10 minutes later, even that call was dropped. Absolutely maddening. Every single call interrupted unexpectedly. Why?

Today, only a day after conveying that we wanted to lodge a formal complaint, contact the ombudsman and submit this review to Hellopeter, we got the call from complaints division. Your airfare upgrade reimbur*****t has been approved.

And . . . we are still awaiting the payment. Our credit card bill payment fired today with the roughly R58000 (3000 euros) in the mix. If we had not pulled from Allan Gray savings a week ago already, we would have incurred massive credit card penalties/ interest. We are fortunate to have the privilege of such savings; and our wits about us to know when the payment is scheduled to make a plan to avoid paying interest.

We remain so thankful that Discovery's International Travel benefit helped us so much whilst overseas - and we have Coastal Core. This travel benefit appears ubiquitous across their offerings. However, the overseas hospital is still unpaid, we have not been fully reimbursed for a claim submitted 3 weeks ago, it appears the deductible is taken for every part of the process and Discovery's phone support is so consistently interrupted we cannot seem to make headway in a timeous manner.

It's no surprise that thankfulness has turned to frustration and disappointment. Even if and when Discovery eventually reimburses us (less the deductible for a third time?), it will be hard to forget how difficult it was to get it. And if they don't pay? Well, it will be even worse to have to go through all the emails, WhatsApps, slips and payments to submit the timeline to the ombudsman to take legal action.

We just wanted to share all this with you, and have these comments and recommendations for Discovery to improve their handling of situations like this with others: - kudos for the international travel benefit; keep it for as many health cover plans as possible. - kudos for covering a rock climbing incident. We have been rock climbing for 33 years and this is the first broken bone ever; and we climb a lot. A lot. - kudos for MSO handling it so well over WhatsApp and email. Really. Especially whilst in the hospital and traveling afterwards. - please don't tell us it's 7-10 working days when it's not. - please don't use AI to read and respond to emails. - please don't ask us to resubmit the same documentation multiple times; it comes across as you stalling for time. - please don't process only part of the claim one bit at a time and charge the deductible again and again. - please don't 'accidentally' hang up on us when we call you or you call us. It felt like every time the conversation got heated, it dropped. Coincidence? Just don't let it happen. - please don't tell us you will pay for something and then not do it; or delay it unnecessarily. - We suggest that Discovery learn from MSO: be responsive and empathetic; follow up (that was the best, really). If MSO used AI chatbots with us, get their software. If MSO support chats were with humans, learn from them. - When you say 7-10 working days, deliver to that timeline. - Lastly, pay up: the hospital ER overseas and us. This is why we've paid you monthly for 25 years, more or less.

Bill and Lizanne Tucker. Discovery # ***