Discovery Making A Bad Situation Even Worse

I have an onging ICB claim with Discovery through my ex employer from 2019 & honestly my experience hasn't been a good one.

Discovery appointed an O.T who ghosted me for months during my work rehabilitation process following disability & in essence because this O.T kept saying towards end 2021 & Jan 2022, Discovery wants to see progress made I felt pressured, so the very first job opportunity that came my way, I grabbed without any sort of assistance & without having any expertise myself, I had to re-integrate myself back into the open labour market. It stands to reason that this attempt was not successful. As a result of this, everything literally went haywire. Now that I was working again & duly informed Discovery, my previous employer at the time very hastily insisted I resign & when I queried how it would affect me, I did not receive satisfactory & even transparent feedback.

Not only was my Discovery Medical Aid & Gap cover cancelled, I was only informed after I had already stuck to my appoinyment with my medical professional that they requested I attend for the ICB claim. Only after expressing my frustration & complaining about it, did the Disability Assessor call me & initially when I asked her what happens to my medical aid & if I were to go 'cold turkey' since I would no longer be able to afford my treatment out-of-pocket as my salary at my new job was too low, only then was my ICB claim partially re-instated. The assessor apologized at the time for the stuff up with their appointed O.T ghosting me & appointed a new O.T.

My issue is that if I didn't bring this to Discovery's attention, they would've just let the situation be & ofcourse as the member I would have suffered. I don't understand why I have to think for Discovery when they are supposed to have the expertise in these matters. Isn't that why they employ trained medical staff for this exact purpose?

When I queried my gap cover, PSG, the brokers I inherited from my ex-employer only advised me now in Aug that I paid preferential rates for gap cover due to my previous employment contract so if I wanted to keep my gap cover it would be almost double the price should I re-instate the policy. Surely as the appointed broker, I should have been made aware of these implications? This is why I loathe dealing with PSG. They are just the middlemen who prolong the chain of communication between myself & Discovery. In my experience, they do not follow TCF because unless I ask the most basic questions, they are not forthcoming with all the required information. They seem to forget that as the experts in their field, they cannot just use long term insurance terminology & assume the average client can decipher long term insurance jargon. FAIS has the same in place for someone like me, an expert in short term insurance & even I know that TCF means I cannot use terminology & assume clients must know what I mean when I use jagon?

I honestly feel like getting a job is when things went terribly sideways with Discovery. They were so focused that I find alternate employment, my best interest was not the main focus. From a financial stand point, it makes business sense to pay only a partial ICB (which only happened when I complained that I could not meet my expenses) or not to pay at all when the member gets a salary equivalent or more then pre-disability or if the member were to die. Dare I say it feels like this would be the best business outcome for Discovery?

In ICB letter feedback dated 18 May 2022, I was informed the ICB will continue as a partial benefit & new reports must be submitted to Disc by 4 July 2022. This was done.

Then ICB letter dated 8 July 2022, I was informed partial ICB benefit would still continue but new reports & case management would continue for 3 months & be reviewed by 8 Oct 2022.

In the interim, the new job didn't work out for reasons known to Discovery & I resigned 14 July 2022. Communication was sent to PSG who had to inform Disc to which I received another ICB letter dated 3 Aug 2022 stating "...partial monthly ICB benefit will be reconciled against the submitted payslip for July 2022." And "As from 01 August 2022, the montly ICB benefit will be re-instated to the full benefit." So the 4th of Aug, I email PSG (since I am forced to deal with them & not Disc directly) why I have only received the same partial ICB benefit amount as when I was employed & received the previous 2 months, the Adviser Assistant rep**** to me the following day, was unable to explain what it meant on the letter when Disc said they would re-concile the partial benefit against the July payslip I submitted to them and she would have to find out & get back to me. Today is the 20th Aug & I still have not received this feedback. I received an email dated 15 Aug saying this query would be sent to the "Payments team" for clarity but lo and behold when I woke up this morning, no feedback on the matter, instead I received the very same monetary benefit I received as a 'partial benefit' whilst receiving the set salary I was getting before I resigned? It doesn't take a rocket scientist to understand the following - Disc benefit pays me R4857.02 as a partial together with salary for June but when I question how it is the same amount as partial benefit for July being fully aware my last working day was the 14 July 2022 yet still receiving the very same amount as working the full month of June (what then happens to the days 15 July - 31 July), no one can answer me? Make this make sense. To add further insult to injury, I awoke to realize that Discovery did not pay me the full ICB benefit as noted in their letter dated 3 Aug 2022 as I have in writing. Now this leaves me to question who is worse between P S G & Discovery? Seems like neither PSG nor Discovery possesses the expertise for a smooth experience with either of them because not only didn't my question seem to make logical sense to the 'Adviser Assistant' who is supposed to be my point of contact as PSG but was my query really sitting with the 'payments team' at Discovery for 5 working days & they still stuffed up my benefit payment? I am truly tired of dealing with both PSG & Discovery & I honestly do not desire to speak to either of them. Because the process of communication between myself, then PSG (unnecessary middlemen why I am not fond of brokers due to this) and then ultimately Discovery, is that the process is time consuming and complicated. Only G o d knows when I will get feedback & ironically if not resolved timeously, my Discovery medical aid debit order will not go through successfully since I have no other form of income & the partial benefit doesn't even cover my medical aid premium in full either. So if this medical aid premium along with all my other set debit orders do not go off, which they won't, who will going to cover all "unpaid debit order fees" penalty to my bank? Let alone ***** up my bank account because my full ICB benefit was not paid? Is it fair that I suffer even more than what I already have to what led with to this disbility claim in the first place? Also, on the ICB letter dated 3 Aug 2022, Discovery moved up the review date by more than a month from the 8 Oct 2022 to the 3 Sept 2022, problem is a month ago when I called for an appointment which one of the medical professionals I am required to obtain a new report from, can only see me the 26 Aug 2022. I even requested his office put me on the cancellation list so that I may see him sooner in order to have the report Disc requires in time for their deadline on the 3 Sept which I have even advised the O.T of. Now this Dr will literally have 5 working days to furnish the requested report (funnily enough, Disc ICB team's turnaround time is 10 days when reports are submitted to them) but if this is not done, I as the member will suffer yet again. This is not being reasonable.

The problem is they have no consideration especially Discovery, knowing full & well what mental state I am in & have been since 2018. Discovery is not making this any easier for me & the people working there have no empathy or even use any tact when dealing with their members. Explain to me how Discovery doesn't realize this experience for someone like me who is already in such a fragile state (you have feedback from the appointed O.T) and also studies you have access to, so tell me how you don't realize that such an experience could literally push me over the edge & make me feel even more helpless? Or is Discovery hoping that this pushes me over the edge & hoping it leads to my death so that they no longer have to pay?

C'mon Discovery, you cannot be so inhumane, can you? I expect feedback in writing via email only, I am in no frame of mind to talk to you.