1 reviews | Active since Dec 2020
Frustrating Service and Ambiguous Terms and Conditions
I am extremely disappointed by the service rendered by this company.
After experiencing severe COVID symptoms, I was advised by a medical doctor to call an ambulance to take me to the hospital as I could not breathe. The ambulance did not take me to hospital as they informed me that I would recover without needing hospital treatment.
Now, when I purchased this cover, I perused the terms and conditions carefully before paying the first premium. These terms and conditions explicitly state that cover would be provided for emergencies which still do not end up in hospitalization. Basically, calling out an ambulance is covered should there be reasonable apprehension that the circumstance in question is an emergency. COVID!
Fast forward nearly 6 months later, the ambulance company is threatening legal action against me because Discovery refuses to pay. Why? Because the wrong code has been selected. Why is this my problem? I have abided to the terms and conditions set by Discovery. I called an ambulance using their App so why was I now instructed to tell the ambulance company to change the code?
God forbid, but should I find myself in a similar predicament in the future, should I rather call an Uber or an ambulance? I keep calling Discovery and I am placed on hold for nearly 20min or someone is working on it, these calls take quite sometime. I have spoken to many consultants and this issue has not been resolved.
Please address the following concern: 1. Why should I be responsible for the payment of this service? 2. Please show me the relevant section of the terms and conditions which state my responsibility in such scenarios? 3. Why is it my responsibility to change codes yet I have no medical experience? 4. As no cover has been provided, do I qualify for a full or partial refund of my premiums as ambulance cover was not provided?
I am tired of using so much time and money with no results. This level of frustration is what I was trying to avoid by choosing a big medical aid. Why are you now providing terrible service? In terms of service, why has my concern not been adequately addressed despite being raised months ago?
This matter has been persistent since July. Should it not be resolved by close of business 08 December 2020 I will have no choice but to raise this with the Ombudsman.
Please check your emails for final feedback from us.
Please check your emails for final feedback from us.
This response you have sent me was clearly just a templated answer to a compelling argument. I was referred to read Scheme Rules regarding ambulance services but the rules make no provision for call out fees or patients having to select the correct codes whilst struggling to breathe. A company full of resources is failing to provide simple answers.
Once again I urge you to show me the relevant provisions of the policy wording or scheme rules or whatever rules provided to me at purchase stage, which contradict those I have highlighted for you already. Show me the obligation for me to be fami**** with the codes used for call out fees. Stop sending me short responses which do not address every point. Hire one of the Sandton lawyers around you to assist with providing adequate feedback because this is really shocking!
Once again I reiterate that I called an ambulance because I was struggling to breath thanks to COVID, Discovery refused to pay the ambulance because I was not transported to hospital.
This response you have sent me was clearly just a templated answer to a compelling argument. I was referred to read Scheme Rules regarding ambulance services but the rules make no provision for call out fees or patients having to select the correct codes whilst struggling to breathe. A company full of resources is failing to provide simple answers.
Once again I urge you to show me the relevant provisions of the policy wording or scheme rules or whatever rules provided to me at purchase stage, which contradict those I have highlighted for you already. Show me the obligation for me to be fami**** with the codes used for call out fees. Stop sending me short responses which do not address every point. Hire one of the Sandton lawyers around you to assist with providing adequate feedback because this is really shocking!
Once again I reiterate that I called an ambulance because I was struggling to breath thanks to COVID, Discovery refused to pay the ambulance because I was not transported to hospital.