GAP COVER CONSULTANTS LIE - PATHETIC

Do NOT apply for cover with Discovery GAP cover The consultant Mukhtaar Salie absolutely misleads you in what you are actually covered for and what not. I am now trying to claim against GAP cover for a co-payment of R4200.00 paid for a hospitalization procedure in which I was assured I was covered by this consultant only to now be told I am actually not.

I logged a complaint on the 3rd August WRefNo# ********** 734#- -MailRef# ********** 520#- requesting the voice recordings be listened to as I was NOT TOLD I would not be covered. I was called on the 11th August confirming my information was correct and the consultant did not tell me. Still not feedback

Again I tried to claim WRefNo# ********** 507#- -MailRef# ********** 259#- only to be declined: Reference number: ********** 507 Dear Mrs Prinsloo Thank you for your email. Discovery Gap Cover Claim We have received and assessed your claims. The claiming process on Gap Cover is automated. Discovery Gap Cover only covers shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission and co-payments on approved cancer-related claims. If there is a co-payment payable prior to a member’s procedure, the client would be liable for the cost as Gap does not cover co-payments. Normal visits to the dentist, general practitioners or radiologists or Pharmacy claims with no hospital admission authorisation number are not covered by Gap Cover but will be taken from your day to day benefits (Medical Savings). Claim pay-outs are subject to an In-Hospital authorisation shortfall after the procedure has been done to the client and not if a client runs. We picked up that the claim for the amount of R4 200 for services rendered from 25 July 2018 until 27 July 2018 does not qualify for gap Cover Funding as it was a co-payment to the hospital for services rendered during the hospital stay. The only co-payments that are funded by Gap Cover are for cancer related claims once a member reaches their Oncology Threshold on their health policy. If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za Regards Siya Gxowa Discovery

Now 18 minutes later and still no help on my refund I am tired of the lies and bull**** from Discovery GAP - how can you employee people who lie or mislead you???

PATHETIC PATHETIC DISCOVERY