POOR SERVICE DELIVERY AND NEGLIGENCE BY DISCOVERY HEALTH

I am sharing my experience with Discovery Health (DH) regarding my father’s medical treatment in the hope that others who have faced similar issues can advise or support. I am his health proxy. On 6 October, my father received emergency care at Ethekwini Hospital. DH rejected payment for ER diagnostic fees and also refused admission, even though: The general waiting period for admission had already passed. The doctors explicitly informed the DH representative working for the hospital that the reason for admission was unrelated to any pre-existing conditions. It took several weeks for DH to inform us that the rejection was allegedly due to the hospital not providing a personal medical assessment (PMA). However, the initial pre-authorisation letter from DH did not mention this requirement, but provided a blanket statement likely sent to all clients whose claims are rejected. No specific reason was provided for the rejected authorisation request. This suggests mismanagement and possibly even *****ulent behaviour on their part. My father fully co-operated with every request. They reviewed his entire medical history and found no reason to reject the authorisation. Since the rejected authorisation, DH has ignored multiple emails from my father seeking further clarity on this matter, despite weeks of continuous follow-ups both by him and myself. Requests to contact their CEO were ignored, and instead we were directed to a generic mailbox that refuses to respond to our queries.

This experience points to gross negligence and potentially ******** misconduct, and I believe urgent action needs to be taken.

If anyone has faced a similar situation with Discovery Health, please get in touch with me. We are considering lodging a case of ******** negligence against them and would appreciate any advice or shared experiences.