Limits being app**** to the unlimited benefit.

I app**** for the al**** theraputic care extender benefit for my autistic son. The benefit CLEARLY states this in writing:

"We only pay for services from certain healthcare professionals

The Al****, The****utic and Psychology Extender Benefit only covers services from acousticians, biokineticists, chiropractors, occupational the******s, psychologists, physiothe******s, social workers, speech-language the******s and audiologists."

It also says: "This cover does not add up to your limit We don’t count the claims for the specified al****, the****utic and psychology healthcare professionals towards your yearly Al****, The****utic and Psychology Benefit limit from the date you register on the benefit."

And lastly: "The Al****, The****utic and Psychology Extender Benefit gives members who meet the benefit entry criteria for certain conditions, unlimited cover for a list of al****, the****utic and psychology healthcare services."

Now all of a sudden they are not paying for my sons Occupational Therapy anymore, the 2 most recent claims were partially paid and NOT paid both stating this

"You have reached the yearly limit for al****, the****utic and psychology healthcare services."

I can also confirm on the benefits tracker it states in big bold letters that my Al**** and Theraputic Care limit is unlimited but only Physio is showing under there in terms of claims and not OT or Speech??

So I reached out to Discovery and got a correspondence from Thiloshini Chetty stating

"Our assessors have provided feedback for the claim dated the 9th of September 2023 for Dr *** for R1,605.00 respective and the 27th of September 2023 for Dr *** for R5,649.00. They advised that you have reached the yearly limit for al****, the****utic and psychology healthcare services. We are unable to pay the claims as the linits are depleted. Please settle with the practitioner."

Now for some or other reason I have apparently reached the yearly limit for unlimited benefit which I SPECIFICALLY WENT UP A PLAN TO GET!!! I am on Classic Comprehensive which as it is, is expensive only to be told the unlimited benefit has a limit.

So my ask is for Discovery to check their systems and fix this ASAP and pay me for the claims I am entitled to (which I know is the Discovery rate). It is working fine for Physiotherapy but NOT for Occupational Therapy which is part of the list.

Contact me ASAP, fix this ASAP.