MSA depleted by Discovery staff

From: Rudy ****ian (Santam) Sent: 06 November 2018 03:19 PM To: ********** ********** Subject: RE: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 206#- -MailRef# ********** 711#-

Hi,

Advise me how long I should wait before I am able to fetch the attached medication for my wife at the pharmacy. I am frustrated and do not understand why a mistake done by your company, however complex the issue can take this long to solve. Does this mean the health and wellbeing of my family needs to be put on hold.

The two things constant on this query since the 16th of October has been “I apologise” & “I escalated the request”.

What is the chances we might:

- stop my frustration - stop escalating - and solve this issue

Rudy Kilian ********** 300

From: ********** ********** Sent: 05 November 2018 12:14 PM To: Rudy ****ian (Santam) ********** Subject: RE: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 206#- -MailRef# ********** 711#-

Dear Mr Kilian Thank you for contacting us. Error with MRI scan claim I apologise again for the frustrations caused by our error in processing your claim. I escalated the request to fix the error i.e. to pay only R2 750.00 of the claim from your Medical Savings Account (MSA) and to refund the balance of the claim to your MSA accordingly. I will provide you with feedback within two to three working days. The reference number is ********** 622. If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za Regards Mishkah Jackson Discovery Health (Pty) Ltd On behalf of Discovery Health Medical Scheme ________________________________________ RE: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 365#- -MailRef# ********** 694#- ________________________________________ • To: ********** ********** • Subject: RE: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 365#- -MailRef# ********** 694#- • From: "Rudy ****ian (Santam)" ********** • Date: Fri, 2 Nov 2018 09:40:00 +0200 (CAT) • Accept-language: en-US, en-ZA • Delivered-to: ********** • In-reply-to: < ********** 694.190152. ********** ********** • References: < ********** 694.190152. ********** ********** • Resent-from: ********** • Thread-index: AQHUcQ90v5Ja2+gi0UCZoiJpV/dL5KU8G+0A • Thread-topic: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 365#- -MailRef# ********** 694#- ________________________________________

Hi,

What is the possibility having this discovery error from the 16 October 2018 sorted out by close of business today.

Regards, Rudy Kilian From: ********** ********** Sent: 31 October 2018 01:47 PM To: Rudy ****ian (Santam) ********** Subject: [EXTERNAL] Health Complaints/Compliments ********** 314 -WRefNo# ********** 365#- -MailRef# ********** 694#- Dear Mr Kilian Thank you for contacting us. I tried to contact you I was unable to reach you on your mobile number ending in 8300 and your work number ending in 1808. Paper claim requested - PCG Morton and Partners Please accept my apologies for the frustrations caused by the incorrect processing of your claim dated 11 October 2018 for R10 909.66 and the repercussions thereof. We have requested a copy of the claim directly from the healthcare professional in order to reprocess the claim correctly. They have confirmed they would send it to us and we will refer it to be reprocessed correctly once received. I will provide you with feedback as soon as I receive it. If you have any more questions, please call us on ***, email ********** or visit www.discovery.co.za Regards Mishkah Jackson Discovery Health (Pty) Ltd On behalf of Discovery Health Medical Scheme ________________________________________ Health Complaints/Compliments ********** 314 -MailRef# ********** 306#- ________________________________________ • To: ********** • Subject: Health Complaints/Compliments ********** 314 -MailRef# ********** 306#- • From: ********** • Date: Mon, 29 Oct 2018 18:31:16 +0200 (CAT) • Delivered-to: ********** • Resent-from: ********** ________________________________________

A new complaint/ compliment has been received on the website. Company: Health Query type: complaints Role: Member Entity number: Category: Claims Member number / ID number: ********** 110089 Email address: ********** Previous issue: RE:#6029-372-593. I have after this call tried to resolve the attached issue with various of consultants and manager with no joy. Also advised your staff that if this is not resolved then my MSA will deplete and future claims will not be covered by my MSA. Yet every time I do my due diligence above and beyond for a mistake not of my doing, the same response plays, “I will escalate this for you”. One of your consultants also advised me that if the mistake has not been fixed and a claim is not honored then me as the client needs to log another query. Please take this email for that log. Current issue: RE:# ********** 921~1. So 10 working days ago a query was logged with the ***-372-593 and to date no resolution as yet. Today I was notified that claims against my medical savings account was not honored. Discovery has always been a very good service provider, but I am starting to believe the rumours in the market. I would really appreciate, no I think I should rather ask you guys a favour to resolve this as my experience thus far does not look like I am paying for my service.

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