RP
Ruan P

1 reviews | Active since Oct 2018

11 Oct 2022, 12:12

Just don't care about their clients

My brother passed away December 2021 because of heart failure.

It was less than a month before his 21st birthday.

Now we are being bombarded by NHLS (blood work) that was done while he was in the hospital but never paid by Discovery Health.

We contacted the NHLS and they told us that discovery rejected the claims and we need to find out why that is the case. Because my parents aren't in a position to financially help, I paid for his medical aid and all his medical bills.

I contacted discovery to only be told they require an executor's letter to be able to process the claim. We phone the court and told them the story. My father became executor by default. We were told by the court that we needed to get an affidavit to change the executor to me ( his brother ). We got that sorted, sent in all the documents to discovery.

Everything was submitted successfully and I got a message reply: "I have loaded consent for <MY NAME> as per the documents sent through.".

I phoned discovery there after and asked to get more details on why the claims are unpaid. The person then told me that the documents aren't the correct documents and I need to get a letter of executor from the court.

This was after the court told us what to do. Discovery is pushing its authority above the court's authority. We are now in a situation where we have a lot of debt because discovery didn't pay it in the first place, and we need to run around and try to get things sorted because they just don't care.

Yeah, and I am only 27 trying to provide for my wife, parents, and grandparents and pay all the medical bills. Good job discovery. Hope you lose all your members. You definitely are losing 2 members worth R3000 a month because of your lack of caring.

Money-hungry machine is all they are. They didn't care when we first tried to get my brother on medical aid, and still, after his death, they still don't care.

Keep away from them. Go to a different medical aid.

0
Replies (5)
Discovery Health
Discovery Health's reply11 Oct 2022, 13:06
Official
Dear Ruan P

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. 
   Regards Discovery Health Servicing Team
Discovery Health
Discovery Health's reply11 Oct 2022, 13:37
Official
Dear Ruan P

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible. 
   Regards Discovery Health Servicing Team
RP
Ruan P's update11 Oct 2022, 14:20
Reviewer Update
It's just pathetic. Got hold of someone in the end that didn't help at all.

Was told that discovery rejected the claim because the hospital didn't send the documents to *** ( or something ) but rather sent it to another email. She then told me I need to send the documents to *** myself.

She went through the documents that were sent through by the hospital and told me I need to get hold of those documents to send to gratia.... It is on the system at discovery but now I need to head to the hospital, try and get hold of someone that has the documents and send it manually to gratia and try and get this sorted.

When I asked if she can send me those documents that I can send, she refused and said she can't send those documents to me.

The documents are on your system. Take the documents, and process them. What is so difficult? Why should I sit with all the admin, stress, and financial burden if we paid the medical aid on time every month?

Stop existing if you can't even do your job correctly. You keep on saying that you care and are the best medical aid in this country. You are just as ******* as the rest of this country.
RP
Ruan P's update15 Nov 2022, 10:16
Reviewer Update
The struggle continues with Discovery.

I sent through the documents by adding them as links to an open google drive. The files are too large to send via email to exgratia@discovery

Received an email back ( 6 days later ), that they can't open the link I need to submit to claims with pdf files.

I then split up the files into smaller files that won't exceed the 25MB limit of email. I could then send it. Now I receive a no-reply mail saying that the files are too large:
"Message too large
Your message couldn't be delivered to *** because it exceeds the size limit. Try reducing the message size and resending.
The response from the remote server was:
552 size limit exceeded"

You have the documents on record. Just process them. I had to pay R490 for the documents. Now I can't even upload them.

We pay you for a service, and now I need to do all the admin and still, somewhere I am blocked because of bad processes. What do you want from me? Do you want me to die so that this can just go away and you don't have to deal with it? What more can I do on my end to ask/plead you to just take the documents on your system and process them?

Having an excuse like: "the documents were sent to the wrong email address" isn't working.

My suggestion for anyone reading this. Stay away from Discovery. My wife and I will be moving to another medical aid that actually cares about its clients.


RP
Ruan P's update15 Nov 2022, 11:46
Reviewer Update
Just split up all the documents into groups not exceeding 6MB. Sent a total of 14 emails with different documents.

Now let's see what the response is.