Sad service when a life is at stake

Words would never be able to express the utter disappointment I feel at this point. Discovery Health apparently prides themselves with service excellence as constantly advertised in the media and marketing but when a situation presents itself for that words to become action the reality is far from the promise.

It is actually quite exhausting to even write this post but I have been left with very little option at this stage. I am currently 5 months pregnant, this is my 8th pregnancy and I have 1 living child. That statement alone will prove the high risk nature of this pregnancy and how crucial everyday and Medical care is. My gynecologist has sent in a motivation requesting additional cover for consultations and scans to ensure that baby is being monitored regularly. PMB at Discovery health has declined my case without written notification or details as to why it was declined. First problem... No communication... The doctors rooms calls in and gets told of the feedback telephonically..reference ***, consultant Khaya I then called in and spoke to a very empathetic and friendly service consultant reference *** Nerisha Sewbhajan. She listened to my query, empathized sincerely and escalated my query to the Client relationship manager as per my request. I then received a call the next day from the CRM Reference *** Prashina Maharaj - Client Relationship Manager her line manager Nataline Panday.

Prashina was extremely arrogant and her tone of the initial call was extremely passive aggressive to say the least. She did not investigate the query or do any due diligence of any sort. She simple called me to reconfirm the decline decision without listening to my previous call or doing anything other than calling me with the intent to say this has been declined so what exactly are you complaining for? In a nut shell... After me requesting for my query to be handed over to another more competent CRM I receive a second call today from Prashina... She started the call with no explanation as to why I'm still speaking to her after requesting to speak to another manager, and she confirmed that the PMB decision was reviewed as an appeal by a board of medical doctors and the decision remains declined... Now I'm expected to complete an unnecessary dispute form because Discovery has all the clinical information already for this to be further reviewed. Prashina decides to explain she understands what I'm going through and I don't need the stress but literally the only thing she has offered me is stress and frustration...

So Discovery Health, just to confirm your board of medical doctors have declined my specialists requests for additional doctor visits and doppler scans to evaluate and monitor regularly my baby's growth and development to prevent a reoccurrence of a loss like previously due to my medical history, co morbodities and high risk pregnancy. So my baby's life is not being regarded my Discovery? In 2019 I carried my baby to 8 months and Bonitas medical aid at the time did approve additional cover.. I am not convinced that Discovery cares about me as a member or my unborn baby for that matter...

Your level of service is pathetic.. I have been in the medical aid industry for 16 years, this present moment I happen to be unemployed due to retrenchment, left without an income and need my medical aid more than ever...yet I am being failed...

Prashina, empathy is not the use to words to relate to a member or make a person feel heard.. Empathy is the ability to put yourself in someone else's shoes. Actions speak louder than words. I am not a Stat... Not another case for notes to be made, a routine call to be made and my query to be closed. I am a person... A pregnant woman... That is fighting for my child to have a fighting chance at life.. Just ticking a box and getting a paycheck at the end of the month should not be your goal... You should strive to be a true ambassador of the brand, I remember when I worked at Discovery health that's what I was taught... And practiced.... Every member is an individual.. Every case is unique... Every voice should be heard and every query attended to in detail... My case is not an open shut one.. Clearly you are not capable of dealing with my query.. Should I just escalate to the Council of medical schemes? Regards Tash Thevan ***