Unnecessary termination of medical aid

Me and my husband joined Discovery on 09-04-2019 and was active on 01 May 2019. We are currently trying to get pregnant and therefore needed a medical aid.

Recently, my husband started to gasp for breath in his sleep. He has however snored for some time now. We have never made mention of this to our house doctor as it did not seem like a problem. (To be honest, we do not have a medical background to think this is a problem). The problem mentioned above came up while having a conversation with friends and they mentioned that my husband should go for a sleep study as they have sleep apnea and have similar symptoms. Please note that this was well after we joined. I then contacted the sleep facility and made an appointment. We were willing to pay privately for this as I am sure this is not the typical thing we should claim for. The facility mentioned to us that Discovery usually pays for this test and that they will send the documentation through for pre-approval as we can claim back.

All documentation from the facility was sent to Discovery. The facility did not finalize the booking, as they needed approval and placed pressure on us. I phoned the medical aid last week to follow up on the process and I was told that Discovery is awaiting to hear from the facility where the study will take place. After sorting that out, we were required to complete a PMA form. On Friday last week I had to phone Discovery as the PMA was never received by our GP. I was on hold for more than 30 minutes to sort this out. The consultant was rude and unprofessional to a point where I escalated my query to a manager.

My husband saw our GP on Friday and the Dr. said in consultation that he has never mentioned this before and only then conducted the questions on the PMA. He asked my husband how long has he been snoring where my husband said for a long time (again, we assumed snoring is normal...). He then asked when did the gasping start and my husband said recently. We do not know what was completed and if this was accurate.

Today, I followed up again as I am pressured by the facility for authorization and have received no feedback from Discovery. She said someone from Discovery will call us back as soon as possible.

This afternoon my husband (Please note, a BENEFICIARY on MY medical aid) phoned me and said someone from Discovery phoned him and said that Discovery is terminating our membership due to non disclosure... After my call with him a Risk Manager named Jillian van Rheenen, phoned me. She asked if my husband has spoken to me yet and then she notified me that our membership is terminated. I explained the whole situation to her. She had no sympathy with our case nor did she make mention of being able to appeal to this decision.

She however said that we will be terminated as of 01-05-2019 and all payments will be paid back, minus the savings used. She also mentioned that she listened to the application call and we made no mention of snoring.... I asked her where that question was and she said that I should have specified it under ENT conditions..... Also she stated that we should have declared the snoring under the question that asked for anything else to be mentioned. This was not used as an example and it did not even cross my mind at that time, especially not with the questions asked.

I even declared that fact that we are trying to conceive and that my husband wears glasses and smokes. Why would I have been dishonest and with hold that small piece of information? I asked for the recorded call to take further action upon this. I received the attached letter of termination, but not the recorded call. I wanted to listen to this, as I believe at that last question I even said, "not that I can think of". Whatever the case may be, I feel this is extremely tragic.

I went on my Discovery app a few minutes ago, to find we have already been terminated. As I refuse to spend any more time and money with Discovery, I have already phoned another medical aid to join, but they can only accept us from 01-09-2019, therefore Discovery now left us without cover for most of the month. My husband travels most of the day and so do I. We are trying to conceive. We paid our monthly contribution on time. Then this is how Discovery treats us.

I have lost my utmost respect for Discovery due to this.

With all of this being said, I will take this case to the council of medical schemes seeing that: -Discovery immediately terminated us before giving us chance to appeal or explain. -Discovery is now terminating is on a date where we cannot get immediate cover straight away. -Discovery might even now be the reason that we are penalized with another medical aid. -Discovery staff treated us with no regard, understanding or respect. -Discovery decided to phone a beneficiary on the medical aid, before phoning the main member, who is paying for the medical aid. -Discovery has not yet sent me the recording of initial call, after me asking twice for this. I therefore resume this is being refused. -Discovery now, not only terminated us, but made our whole membership INVALID. - As per your own wording: "We conducted a detailed investigation and we received information confirming that your dependent has been suffering from sleep apnoea and snoring for 2 years." Sleep apnea was never diagnosed, nor considered, therefore, please indicate where this information came from?

I am disgusted by the treatment we received. I feel Discovery could have rejected the procedure as we would have paid for this ourselves instead we now have all this drama and uncer*****y. In the past I have recommended Discovery highly, I will never again due to this treatment. I feel that should Discovery have felt so strongly about making us feel like *********, this could have been handled better and someone with compassion, care and understanding should have phoned us.

We have paid a great amount in monthly contributions, we will gladly take our money elsewhere if this is not good enough for Discovery.

Thank you Discovery, I have seen a side of this medical aid making me re-consider all connections and referrals to Discovery.