POOR communication from Discovery Health's claims department.

Introduction: I suffer skin cancer spots that make there appearance from time to time. With our package at Discovery Health, we have to seek approval before we get to see a medical specialist. The dermatologist I usually go to see do not deal with medical aids directly. So, whenever I go to see him, with an approval from Discovery Health, I have to pay him directly and then later claim the expense from my medical aid. This also goes for the pathology services. In July 2020, I went for treatment of some spots on my skin and as said, I paid for it and also for the pathology services. Both statements with prove of payment was submitted to Discovery's claims department. Confirmation of receipt of the claim was provided but nothing further was heard from Discovery Health. I then learnt - not from Discovery Health - that I may need to register for oncology with them, which I then did. The registration was confirmed by Discovery Health but I also received a nice telephone call from them. I discussed my outstanding claim with this person and was advised to resubmit the claim which I did - that is the 2nd submission of the claim but again I heard noting from Discovery's claim department. When I checked the documentation to confirm everything was in order I found that the dermatologist's admin **** out the receipt to the wrong person. I had this rectified and resubmitted the claim and the following is how things went from there: Claim 22-12-2020 – 3rd claim submission: from: Pieter I. du Plessis <***> to: Discovery Claims <***> date: 22 Dec 2020, 14:48 subject: Membership no. *** - claim under approval no. ***6 - Dr. Procter and Ampath Good day, I have found a discrepancy in the documents with my previous 2 submissions of this claim - you did not inform me of this, neither that the claim was rejected or not. Certainly not good service, from a supposed to be a prominent medical aid like you.

Nevertheless, Dr. Procter's admin made the receipt for payment out to an unknown party. This has now been rectified.

Attached, please find the following documents: 1. App no. ***6 Dr Statement&payment ***1 w. corrections 2. App no. ***6 Path Report ***4 3. Pathology Statement - approval ***6 refers 4. Notice of Payment

Kind Regards Pieter du Plessis ***1 ***

Acknowledgement received to the claim above on 22-12-2020: from: No- *** to: *** date: 22 Dec 2020, 14:50 subject: Membership no. *** - claim under approval no. ***6 - Dr. Procter and Ampath -MailRef#***#- mailed-by: discovery.co.za Signed by: discovery.co.za Dear Member Thank you for your email. This is an automated response to acknowledge receipt of your claim(s). Your request will be processed within 2-3 working days. Your reference number is ***, and the details of these claims will reflect on your next claims statement or notification. Please do not reply to this email.

Note: On the 24th December 2020, I received a phone call informing me that prove of payment for the pathology services, was not attached - please refer to the 4th document attached. Needless to say I lost my cool at this but I confirmed that it was. I had no number to phone back and I responded somewhat snottily by email to the claims department. Discovery’s response to Claim 22-12-2020 on 26-12-2020 from: *** to: ***

date: 26 Dec 2020, 20:16 subject: Fwd: Membership no. *** - claim under approval no. ***6 - Dr. Procter and Ampath - MailRef#***#- mailed-by: discovery.co.za Signed by: discovery.co.za security: Standard encryption (TLS) Learn more

Dear Member Thank you for your email. This is an automated response to acknowledge receipt of your claim(s). Your request will be processed within 2-3 working days. Your reference number is ***, and the details of these claims will reflect on your next claims statement or notification. Please do not reply to this email.

Nothing has been heard since.