TE
Tanique E

1 reviews | Active since Jun 2017

01 Jul 2017, 12:30

******** Termination of Contract

<p>To start with i have moles (legions) one on my lip which I have enjoyed over the years and a few others on my back and neck. I have never had any issues with moles(legions)</p> <p> </p> <p>I signed a contract with Discovery health on 07/02/2017. My broker and I filled in the application form truthfully and honestly.</p> <p> </p> <p>I did not check the box that askes for pre-cancerous skin lesions because I have never been diagnosed with pre-cancerous skin lesions and I have also never had any problems with my moles (lesions) before signing up with Discovery.</p> <p> </p> <p>In April 2017 one of my lesions (on my upper lip) started to change shape and became sensitive. I then contacted a dermatologist and made an appointment for 05 June 2017.</p> <p> </p> <p>In the appointment he examined all my lesions and determined that the one on my upper lip as well as one on my back had started to show signs of becoming pre-cancerous.</p> <p> </p> <p>The Dermatologist referred me to a plastic surgeon for the operation (because of the difficult placement of the mole on my lip) and I met with her on 15 June 2017. She agreed that the lesions needed to be removed and booked a date for the surgery. The surgery was pending by Discovery and was booked for 23 June 2017. After not receiving authorisation, (and following up many times)the surgery was moved to 30 June 2017. The doctor was requested to send in an extra report.</p> <p> </p> <p>On 28 June I was contacted by Ms. Rosanna Kinloch. She asked me many questions about my moles - which i did find odd - but co-operated, thinking the quicker I answer, the quicker I can get the Authorisation Number for the surgery.</p> <p>She then requested that I send her two photos of the lesions and assured me that everything is ok and this is normal procedure. I sent her the photos and a short while later I received a phonecall from her stating that my membership with Discovery had been revoked due to aledged non-disclosure. Of course i was shocked and very confused as I filled in the form with the help of my broker truthfully. I asked her what non-disclosure and she said I should have ticked yes to legions. (The question states pre-cancerous legions)</p> <p> </p> <p>Ms Rosanna claims that the lesions are pre-canscerous lesions and therefor needed to be checked on the application form.</p> <p> </p> <p>However, at the time of application these lesions were not pre-cancerous and had never given any problems before. They were just normal lesions that had developed into pre-cancerous lesions after the contract with Discovery was signed.</p> <p> </p> <p>Ms Rosanna also states that the report written by the doctor clearly stipulates that I have had the lesions for many years. This is correct. I have had them for many years. The doctor's report also stipulates that they have only recently become a problem. This part Ms Rosanna clearly misunderstood or just ignored. The lesions had been on my body for many years but only recently became pre-cancerous.</p> <p>(Apparently one needs to count evey mole on there body and disclose this)</p> <p> </p> <p>Ms Rosanna has based her non-disclosure claim on a photo that was taken almost 5 months after the contract with Discovery had been signed. If any conclusion can be drawen from these photos then it is only to serve as evidence that the claim should be approved. As it shows that the lesions are pre-cancerous at the time the photos were taken (28/06/2017). Along with this she backs up her claim by reading only partially the report sent in by the doctor and not acknowleging the fact that the report clearly states the lesions had only resontly become a problem and were not infact a problem before the contract was signed.</p> <p> </p> <p>The fact of the matter here is simple:</p> <p>At the time of signing the contract I had normal lesions (non-cancerous). Approximately two months after the contract was signed they started changing shape and becoming sensitive, and I decided to get them checked out. They were diagnosed as pre-cancerous for the first time on June fith 2017.</p> <p> </p> <p>Ms Rosanna claimes I needed to check the box on the application form stating that I had pre-cancerous lesions at the time of signing. And this was not the case.</p> <p> </p> <p>In order for this alledged non-disclosure to have been committed I need to have been examined by a dermatologist before the signing of the contract with Discovery and the Dr. had to have told me and written a report stating that I have pre-cancerous lesions. This never happened.</p> <p> </p> <p> I am appaled at Discovery and Ms Rosanna's Handling of this situation.</p> <p> </p> <p>At the moment im not even covered by any medical aid and they want me to re-apply with them and then they will exclude this surgery for 12 months - not acceptable, as the claims of the non-disclosure are false.</p> <p> </p> <p>So, I would like my membership to be re-instated, and the procedures cleared again immediately as well as receive a formal appology from Ms. Rosanna Kinloch.</p> <p> </p> <p> </p> <p> </p>

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Replies (2)
Discovery Health
Discovery Health's reply03 Jul 2017, 09:41
Official

Dear LadyT001

We’ve noted your concerns and we’re investigating the matter. We’ll contact you with feedback as soon as possible.

Regards
Discovery Health Servicing Team

Discovery Health
Discovery Health's reply04 Jul 2017, 13:38
Official

Dear LadyT001

We have been in touch with you to answer your comments.

Regards
Discovery Health Servicing Team