**** Poor service delivery

Thank you I received a response and call but the matter is still not resolved see email below to which i received with a reference number and stating it would take between 7 and 14 working days for this matter to be resolved and it been referred to Life insurance department.

My consern is I am not Johan Van Der Heever and that My supplementry claim has made no further progress to were i was on the 17 February as it 16 March 2022 its been 3 months now.

I think you are in breach of the popia act as you disclosed personal information of another member to Me with out his consent

I have discussed this with Bongani and Gap cover Claims department and his has advise that they are still in the process of the claims apparently So he was helpfull.

Good day

Thank you for contacting us.

We acknowledge receipt of the completed Supplementary Illness Benefit claim forms and have referred the query to our Life Claims Assessors to assist with reviewing the information.

The turnaround time for this process to be completed is 7 – 14 working days.

If you have any more questions, please visit www.discovery.co.za, email ***, or call us on ***.

Regards
Chuma Mayekiso
Discovery

[Email from external sender. Proceed with caution.]

I just hear excuses. What is the point of a gap cover that doesn’t cover the gap? Terribly disappointed. Johann van den Heever
B.Eng (Civil) Msc.Eng (Pavements)EngineerM: +***1
T: +***0
E: ***
W: www.mpamot.co.za Website | Twitter | LinkedIn | Facebook Mott MacDonald Africa (Pty) Ltd, is wholly owned by MPAMOT Pty Ltd.All projects will be honoured and completed by the personnel clients have been working with, and our teams will continue to striveto deliver excellent service to our clients. For queries please contact us on ***The information contained in this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/orprivileged material. If you are not the intended recipient of this e-mail, the use of this information or any disclosure, copying or distribution isprohibited and may be ********. If you received this in error, please contact the sender and delete the material from any computer. From: *** <***>
Sent: Monday, 21 February 2022 11:17
To: Johann Van Den Heever <***>
Subject: Gap *** -WRefNo#***#- -MailRef#***#- | You don't often get email from ***. Learn why this is important | Reference number: ***Dear Johann Van Den HeeverThank you for your email.Claim reviewBelow please see details of the attached claim as requested: Claim number | Service date | Amount claimed | Amount paid by Gap | Reason code | Provider name
9I9LqW | 2022/01/31 | R1200.00 | R0.00 | 1072 | VAN ZYL J L N INCORPORATED Reason Code 1072: This shortfall is only covered when it relates to an authorised hospital admission occurring within a defined period from this service date. The member is liable for shortfall.Discovery Gap 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, depending on the product chosen.Discovery Gap Cover will not cover any claims that are not paid by the medical aid due to the Medical Savings Account being depleted.If the medical aid rejects a claim, Gap Cover will ultimately decline the claim as well. Claim pay-outs are subject to an authorised hospital admission and not if a client runs out of medical savings account. With no authorisation, the claim does not qualify for gap Cover Funding.If you have any more questions, please visit www.discovery.co.za, email ***, or call us on ***.Regards
Lumanyano Goba
DiscoveryGap ***To: "***" <***>Subject: Gap ***From: Johann Van Den Heever <***>Date: Fri, 18 Feb 2022 09:15:39 +0200 (CAT)Accept-language: en-USArc-authentication-results: i=1; mx.microsoft.com 1; spf=pass smtp.mailfrom=mpamot.com; dmarc=pass action="" header.from=mpamot.com; dkim=pass header.d=mpamot.com; arc=noneArc-message-signature: i=1; a=rsa-sha256; c=relaxed/relaxed; d=microsoft.com; s=arcselector9901; h=From:Date:Subject:Message-ID:Content-Type:MIME-Version:X-M****change-AntiSpam-MessageData-ChunkCount:X-M****change-AntiSpam-MessageData-0:X-M****change-AntiSpam-MessageData-1; bh=snK0USShMyBErPk2dRkfV2ULL+cjLIFUtbTHQdTUmYA=; b=h+UmEeilJENevKWu0mkW0J3X6rQET0gO1xLr2PVfXMSqc62uomyiH6cuvSbq9/qqhJgTrFr32PRTkteKRtp5txPtxsA5aGAqPlwFz/8R8x5U1tC3yYDvzIiTZUYC3ki956aVag8ZLuaaVoNXH0P5BAWI9ueUZ1ijxCv43W0eSXACLvlf3/0/wzsJienM0XpKMU0TORTo4puoHJESGivFf2hlOJ6LdTFDKUF60qeU4270SeknfTdC3EC8XCuC5CnKyNuZQtT3agkNR+u034x2VdB89sVGv11fLBY4J1w0wMzv3z92Po7LyVT0Sy84vx3Z3NTHEMfYzL38bEJhNy6FLQ==Arc-seal: i=1; a=rsa-sha256; s=arcselector9901; d=microsoft.com; cv=none; b=WdjBYVRUKAdLtXgyU0bo2eLCLg/AOKiSL60I53eIcJ8Z5akpULwch6Fqd8IipTlSJAbLp4Ck7gFNvNf8hlunJL3oite4je2ps7wDC+gZvAurmWq4BDXxyWNYDpd8CD+1gMyu/l22IM/lyLg1KNotrBTK8k7T8ohQ9Y6TiOA1qFDW1uTzNXkSos8ulLyNFIhYOpDpdqtw/az7MIal+2z/vtgZAgL/oYG2JU0fkjgIZSgGtcpHpl1iQhIj1Y+WnHyThYlrnnwFbyIKJdj5gCxcKTFlShPlkR8Z2ZbKiwgyhkSJnmBS9DsstR15FETzUZ4/TMHFsSY2+6iK6RQWSKCqfg==Delivered-to: ***Resent-from: <***>[Email from external sender. Proceed with caution.]Hi I recently put in a claim where my medical aid only covered a part of the fees. Reference nr - 9I9LqW. This was your reason for not paying the claim –1072 | This shortfall is only covered when it relates to an authorised hospital admission occurring within a defined period from this service date I have comprehensive gap cover; how can you say that this is not covered. What is the point of gap cover if it does not cover the shortfall? I pay over R800 a month for this gap cover service; please can you relook at this claim. Regards Johann van den Heever
B.Eng (Civil) Msc.Eng (Pavements)EngineerM: +***1
T: +***0
E: ***
W: www.mpamot.co.za Website | Twitter | LinkedIn | Facebook Mott MacDonald Africa (Pty) Ltd, is wholly owned by MPAMOT Pty Ltd.All projects will be honoured and completed by the personnel clients have been working with, and our teams will continue to striveto deliver excellent service to our clients. For queries please contact us on ***The information contained in this e-mail is intended only for the person or entity to which it is addressed and may contain confidential and/orprivileged material. If you are not the intended recipient of this e-mail, the use of this information or any disclosure, copying or distribution isprohibited and may be ********. If you received this in error, please contact the sender and delete the material from any computer.