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JOHN F

1 reviews | Active since Jan 2024

05 Feb 2024, 10:44

DISCOVERY LIFE , This is My Story , John Fourie.

29 January 2024 “Without Prejudice”

Attention: Mr Adrian Gore and CEO – Mr Riaan Van Reenen (Discovery Life)

Per Email: ***; ***

Per Email: ***

Per Email: ***

Dear Sir,

Formal Complaint – Discovery Life – Mr John Fourie – Policy Number: *** – Claim reference Number: 95802

The aforementioned has reference. I am appealing to you for resolution on a Discovery Life matter. I have been a loyal Supporter of your Brand and Vison for more than 20 Years, I have ALL my investments in your company and pay more than 50% of my monthly income to ensure that I have peace of mind and feel safe for my family.

This is MY STORY....

I am JOHN FOURIE (I am on the road to Mental Health Recovery…) My story could have been avoided. I have suffered from Mental Health related issues since last year May 2023, I have been admitted to Hospital several times last year to find a way to support my condition and unpack solutions to ensure a Full Recovery. This would allow me to report for Duty at my place of employment, and change people’s Lives.

I had comfort that DISCOVERY Life would be there to guide and assist me through this process, DISCOVERY Life Should provide me with Income protection for the short term, and retain my employment, as well as support my Family. Since May 2023 I have had NO SALARY INCOME and have been at DISCOVERY Life’s Mercy to do the RIGHT and Honourable Thing. Above is my Reference number, I’m sure you or your Assistant will have access to my history. (I refer to the below mentioned with complete timeline of communication to your firm from my financial advisor for ease of reference…..Nicole Muller : *** ). My Support team (Neuro Surgeon, Neuro Psychiatrist, Neuro Physician, Cardiologist and Physician) IN MY OPINION, we have conformed to all Criteria required by Discovery Life at the beginning (May 2023)when we submitted my claim as per your Contract, your support team have been stalling the process ever since. It is now more than 9 months later with no resolution or formal response. The implication of this delay has led to “my” almost Bankruptcy having to sell off assets to fulfil my financial obligations and then being admitted on the 16th January 2024 to a MENTAL HEALTH facility for 8 days. I pay your company in excess of R 20,000,00 per month FOR LIFE COVER (after VAT) for the protection and personal safety. Your company is NOT living up-to your vison.” To enhance and protect their lives” which is recorded on your company website!!!!!!! I am appealing to you to intervene and Honour your Vison. I am requesting that I receive formal feedback with actionable response and not just an acknowledgement before Close of Business 01 February 2024. Failing which, I shall exhaust all opportunities available to me, which will include, inter alia,:- • Exploring Social Media platforms (i.e. Instagram , Facebook , Hello Peter , Linkedin, etc… ) • Exploring Radio and Television platforms (i.e.Biz News, Daily Maverick, Good Hope FM, SA Talk Radio) for me to share My Story ASAP, if needs be, we will send to Carte Blanche (John Webb) to register , D.D… MY STORY I would appreciate your urgent attention and co-operation for resolution in this regard. Kindly note, My rights are reserved in full. John Fourie *** ***.

Despicable Discovery

Care Insurance . Medical Aid . Bank. Life Insurance. Gap Cover. Vitality.

Company Mission Statement (All Downloaded from the Company Website , I reserve my Rights to Freedom of Speech)

Discovery is a proudly South African-founded financial services organisation that operates in the healthcare, life insurance, short-term insurance, long-term savings, banking and wellness markets. Since inception in 1992, Discovery has been guided by a clear core purpose - to make people healthier and to enhance and protect their lives. We have been able to do this by pioneering the Shared-value Insurance model, which delivers better health and value for clients, superior actuarial dynamics for the insurer, and a healthier society. The success of the model in the markets where we operate has been testament to its importance to society. Our Shared-value Insurance model To make people healthier and enhance and protect their lives, we must look at what compromises their health, wealth and safety, and the context we operate in. Our Shared-value Insurance model delivers better health and value for clients, superior actuarial dynamics for the insurer, and a healthier society. Key to delivering on our model, is a deep understanding of the reasons for the shift in the nature of risk.

My Last Moment of Hope MAY 2023 – JAN 2024 ( 9 Months of DD Trauma ) “Policy number: *** Claim number: 95802 Good day

Thank you for contacting us. We have referred your email and medical reports to the assessor, feedback will be provided as soon as possible. For more information, you can call us on ***or email *** Claim requirements should be submitted directly to *** to avoid delays in processing. Regards

Buhle Mabaso Discovery Life Claims Department” “Adrian Gore founded Discovery in 1992, with a core purpose of making people healthier and enhancing and protecting their lives. Discovery has since evolved into a diversified and multinational financial services group.”

Nicole Muller Claims Assessor Individual Life Claims Email: *** Requirements: *** Office: ***1 Discovery Place, Sandton, 2196 Financial Advisor last Communication to Discovery Life

To whom it may concern, Policy Number: *** Policy Owner: Polo Trust Life Insured: JH Fourie • The life insured had a transient ischemic attack on 20 May 2023 and was booked off by his treating doctor, Dr Warren Stilwaney. He was booked off from 20 May 2023 – 02 October 2023. • On 27 July 2023 we informed Discovery of the life insured’s illness, we submitted a claim for the Severe Illness benefit and the Income Continuation Benefit. • On 02 August we received feedback from claims that the claim for the Severe Illness Benefit was declined and that we must wait for the end of the 3-month waiting period to claim under the ICB benefit. • The 3-month waiting period on the ICB came to an end on 20 August 2023. • On 24 August 2023, we submitted a letter from Dr Stilwaney to Discovery stating that the life insured has had 2 transient ischemic attacks. • On 14 September we receive feedback from Discovery stating that they take note of the submission to consider a claim under the ICB benefit. The request is to provide a sick note with motivation to extend the sick leave. • On 15 September we send the Sick Note from Dr Stilwaney again together with a report from Dr Kate McMullen. • On 12 October 2023 we receive a letter from Discovery Claims asking for outstanding information • On 25 October, we provided Discovery Claims with the outstanding information requested. • On 02 November 2023, Discovery asks for financial statements. • On 06 November 2023, we inform Discovery that the life insured is no longer a business owner of Sauce-ing and therefore does not have access to the financial statements. • On 07 November Discovery asks whether the business was deregistered. • On 28 November, we phoned to follow up because no feedback is received from Discovery Claims. The broker speaks to the claims assessor, Nicole Muller. Nicole confirms that the case’s been sent to the Chief Medical Officer. • On 28 November 2023, the financial advisor asks Discovery make ex Garcia payments to this client for period until 01 October. The client has serious cashflow issues and struggling to afford the Discovery premium of R20k per month. • On 30 November 2023, we receive feedback from the claims assessor Nicole Muller, that the Chief Medical Officer that they will only look at the ICM claim if Dr McMullen will provide them with a sick note booking JH Fourie off for a specified period. • On 01 December 2023, we provide them the Dr McMullen’s sick note. • On 11 December 2023 Discovery asked for feedback on additional reports needed, a report from the Occupational The****** and a report from Dr Retief. Confirmation was sent that there are no reports from those specialists seeing as he has not yet met with them. In summary: 1. Discovery claims does not provide timeous feedback. 2. We provided two notes from two different doctors confirming that the life insured cannot work. We also provided detailed letters and doctor’s reports. 3. The life insured have not earned an income from his employer for 6 months, yet he must support his family and pay the R23k monthly premium on his Discovery life insurance policy. 4. We find that Discovery claims totally disregards the client’s situation and keep on asking for more information rather than paying out the claim. We ask that you review the above and make contact with the claims assessor, Nicole Muller. If we are not satisfied with your feedback within 6 weeks, we will contact the FAIS Ombudsman. Regards, Liezl du Plessis Advisory Partner T: +***2 • M: +***8 • E: *** • www.citadel.co.za

My Initial Physician Dr Stilwaney Today, Discovery reached out to propose a settlement of 3 months compensation, they requested that the above Physician needs to Motivate why my initial sick note was so long, talk about undermining a Highly Regarded Physician in Paarl. Despite his motivation below, they have asked me to sign a settlement agreement ( exploitation of a person who has faced financial difficulty ) …….. DISCPICABLE ….. CLINICAL NOTE: LETTER OF MOTIVATION_LIFE INSURANCE Mr JH FOURIE 1966-12-17 (56Y8M) Male 2023-08-23 Dr A ER24 DISCOVERY HEALTH EXECUTIVE PLAN ***0 Main Member 963 To whom it may concern, Mr. Fourie has been under my care since May 2023 after presenting with the clinical picture of transient ischemic attack (TIA/ICD10: G45.9). Mr. Fourie presented with symptoms of unilateral vision loss mild weakness in his right arm. Most symptoms had resolved during the assessment and the neuroimaging showed no ischemic lesions. This was in keeping with a TIA. Mr. Fourie had some weakness in his right arm/hand during this time. I treated him medically and have followed up with him in my consultation rooms. However, at the end of July 2023 Mr. Fourie again report neurological symptoms of speech deficit and temporary vision loss. Again, the clinical picture of that of TIA. This was again confirmed by neuroimaging. Mr. Fourie has thus had 2 episodes of TIA. He medical treatment has been optimized. He has however been off work and without a salary since the initial presentation. My hope is that this letter assists in motivating for Mr. Fourie to receive full compensation for his loss of income. We appreciate your support and understanding. Kind regards, Dr WG Stilwaney 2023/08/23 ( Specialist Physician ) . CONFIDENTIALITY NOTICE The information contained herein is intended for use by the individual to whom it is addressed. It may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are NOT the intended recipient, you are hereby notified that any distribution, dissemination, copying or any use of this communication in any form is strictly prohibited. If you have received this communication in error, please notify the sender immediately and destroy the original, without retaining any copies. E. & O.E Generated by VeriClaim on 2023-08-23 21:43:31 Patient Date of Birth (Age) Gender Date Referring Provider Funder Option Member No Dep Code Relationship AccNo/FileNo 1 of 1

JANUARY 29th 2024 ( 3month exploited settlement instead of 6 months ). Policy number: *** Claim number: 95802 Dear Mr Fourie We have approved the claim We have received your claim under the Income Continuatiobn Benefit. The claim is valid for the period of disability from 31 August 2023 (the date when you first saw Dr McMullen) until 29 February 2024 (as per Dr Retief's report), less the 3 month waiting period. We are currently processing the claim payment. Please allow two working days for the payment value to be confirmed and finalised. The breakdown of the payment value will be detailed in the settlement letter that you will receive once we have made the payment. We are following with Dr Stilwany for the required medical information to consider your claim from May 2023 to August 2023. We will continue the assessment and provide you with a decision once the information has been received from Dr Stilwaney. For more information, you can call us on ***or email *** Claim requirements should be submitted directly to *** to avoid delays in processing. Regards Nicole Muller Discovery Life Claims Department

Nicole Muller Claims Assessor Individual Life Claims Email: *** Requirements: *** Office: ***1 Discovery Place, Sandton, 2196

0
Replies (1)
Discovery Life
Discovery Life's reply05 Feb 2024, 11:01
Official
Thank you for raising your concerns with us.

We have escalated your complaint to our Claims Management Team for their urgent attention. A Manager from this department will contact or respond to your concerns accordingly.

Regards,
Discovery Life