Dreaded desease and mental illness
My son is overseas and continues to pay for his life policy. He has dreaded desease cover but apparently his diagnosis of bipolar disorder is not covered. In England it is recognized as a serious illness and he is exempt from office work as he bombs out in stressful environments. The very definition of desease as below... disease /dɪˈziːz/ Learn to pronounce noun a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.
Being unable to work and provide for oneself is surely a dread as below
dreaded /ˈdrɛdɪd/ Learn to pronounce adjective regarded with great fear or apprehension. Surely policies should consider mental illness and mental health to be a serious issue? Just saying..
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Discovery Life's replyOfficial
13 Oct 2020, 13:14Dear Kathleen S
Thank you for taking the time to speak to me with regards to the above post.
As confirmed, this is not a complaint but a comment. We will however refer the comment to our Claims Department to assist with a possible claim submission or confirmation of information related to the benefit.
Regards
Precious
DISCOVERY LIFE
Thank you for taking the time to speak to me with regards to the above post.
As confirmed, this is not a complaint but a comment. We will however refer the comment to our Claims Department to assist with a possible claim submission or confirmation of information related to the benefit.
Regards
Precious
DISCOVERY LIFE
Discovery Life's reply13 Oct 2020, 13:14
Official
Dear Kathleen S
Thank you for taking the time to speak to me with regards to the above post.
As confirmed, this is not a complaint but a comment. We will however refer the comment to our Claims Department to assist with a possible claim submission or confirmation of information related to the benefit.
Regards
Precious
DISCOVERY LIFE
Thank you for taking the time to speak to me with regards to the above post.
As confirmed, this is not a complaint but a comment. We will however refer the comment to our Claims Department to assist with a possible claim submission or confirmation of information related to the benefit.
Regards
Precious
DISCOVERY LIFE
's updateReviewer Update
13 Oct 2020, 13:48Thank you for the rapid response. I will wait to hear from the claims department before making any further statements.
's update13 Oct 2020, 13:48
Reviewer Update
Thank you for the rapid response. I will wait to hear from the claims department before making any further statements.
's updateReviewer Update
15 Oct 2020, 10:46This is the email response I received
Discovery placed a Mental and Behavioral exclusion on the Capital Disability Benefit on 26 May 2014 in view of material medical information not being disclosed by Mr Teoule on the application form completed on 05 May 2011.[My comment to you... How would he have known of any illness at the time as it was only declared AFTERWARDS] This means that we will not be able to consider any claim for a psychiatric condition under the Capital Disability Benefit due to the existing exclusion. Mr Teoule requested us to review our decision and he was advised on 05 September 2014 that our decision remained unchanged [His medical aid paid for cronic medication. Until such time as he no longer was in a possition to continue funding his medical] His Severe Illness Benefit does not carry a Mental and Behavioral exclusion, however this benefit does not offer cover for any psychiatric [Pray can you explain this in layman's terms ]conditions and as a result we will not be able to consider a claim under this benefit for any psychiatric conditions. While we are sympathetic to the impact of the Bipolar Disorder on his daily life, the severe illness claim assessment is consistent with the defined benefit criteria which remains the benchmark against which all claims are assessed, but also in terms of Discovery Life’s approach to providing coverage which is commensurate with the impact of the client’s illness. The Severe Illness Benefit is based on a series of defined medical criteria and triggers, this avoids any subjectivity in the determination of a claim. From our perspective, the integrity of the claims definitions is important because any deviation from the policy conditions would not only set a precedent [LOL - he is living with issues and you are worried about precedents?!?] for the future but would necessitate us reverting to any policyholders who may have been in a similar situation to Mr Teoule in the past.
Discovery placed a Mental and Behavioral exclusion on the Capital Disability Benefit on 26 May 2014 in view of material medical information not being disclosed by Mr Teoule on the application form completed on 05 May 2011.[My comment to you... How would he have known of any illness at the time as it was only declared AFTERWARDS] This means that we will not be able to consider any claim for a psychiatric condition under the Capital Disability Benefit due to the existing exclusion. Mr Teoule requested us to review our decision and he was advised on 05 September 2014 that our decision remained unchanged [His medical aid paid for cronic medication. Until such time as he no longer was in a possition to continue funding his medical] His Severe Illness Benefit does not carry a Mental and Behavioral exclusion, however this benefit does not offer cover for any psychiatric [Pray can you explain this in layman's terms ]conditions and as a result we will not be able to consider a claim under this benefit for any psychiatric conditions. While we are sympathetic to the impact of the Bipolar Disorder on his daily life, the severe illness claim assessment is consistent with the defined benefit criteria which remains the benchmark against which all claims are assessed, but also in terms of Discovery Life’s approach to providing coverage which is commensurate with the impact of the client’s illness. The Severe Illness Benefit is based on a series of defined medical criteria and triggers, this avoids any subjectivity in the determination of a claim. From our perspective, the integrity of the claims definitions is important because any deviation from the policy conditions would not only set a precedent [LOL - he is living with issues and you are worried about precedents?!?] for the future but would necessitate us reverting to any policyholders who may have been in a similar situation to Mr Teoule in the past.
's update15 Oct 2020, 10:46
Reviewer Update
This is the email response I received
Discovery placed a Mental and Behavioral exclusion on the Capital Disability Benefit on 26 May 2014 in view of material medical information not being disclosed by Mr Teoule on the application form completed on 05 May 2011.[My comment to you... How would he have known of any illness at the time as it was only declared AFTERWARDS] This means that we will not be able to consider any claim for a psychiatric condition under the Capital Disability Benefit due to the existing exclusion. Mr Teoule requested us to review our decision and he was advised on 05 September 2014 that our decision remained unchanged [His medical aid paid for cronic medication. Until such time as he no longer was in a possition to continue funding his medical] His Severe Illness Benefit does not carry a Mental and Behavioral exclusion, however this benefit does not offer cover for any psychiatric [Pray can you explain this in layman's terms ]conditions and as a result we will not be able to consider a claim under this benefit for any psychiatric conditions. While we are sympathetic to the impact of the Bipolar Disorder on his daily life, the severe illness claim assessment is consistent with the defined benefit criteria which remains the benchmark against which all claims are assessed, but also in terms of Discovery Life’s approach to providing coverage which is commensurate with the impact of the client’s illness. The Severe Illness Benefit is based on a series of defined medical criteria and triggers, this avoids any subjectivity in the determination of a claim. From our perspective, the integrity of the claims definitions is important because any deviation from the policy conditions would not only set a precedent [LOL - he is living with issues and you are worried about precedents?!?] for the future but would necessitate us reverting to any policyholders who may have been in a similar situation to Mr Teoule in the past.
Discovery placed a Mental and Behavioral exclusion on the Capital Disability Benefit on 26 May 2014 in view of material medical information not being disclosed by Mr Teoule on the application form completed on 05 May 2011.[My comment to you... How would he have known of any illness at the time as it was only declared AFTERWARDS] This means that we will not be able to consider any claim for a psychiatric condition under the Capital Disability Benefit due to the existing exclusion. Mr Teoule requested us to review our decision and he was advised on 05 September 2014 that our decision remained unchanged [His medical aid paid for cronic medication. Until such time as he no longer was in a possition to continue funding his medical] His Severe Illness Benefit does not carry a Mental and Behavioral exclusion, however this benefit does not offer cover for any psychiatric [Pray can you explain this in layman's terms ]conditions and as a result we will not be able to consider a claim under this benefit for any psychiatric conditions. While we are sympathetic to the impact of the Bipolar Disorder on his daily life, the severe illness claim assessment is consistent with the defined benefit criteria which remains the benchmark against which all claims are assessed, but also in terms of Discovery Life’s approach to providing coverage which is commensurate with the impact of the client’s illness. The Severe Illness Benefit is based on a series of defined medical criteria and triggers, this avoids any subjectivity in the determination of a claim. From our perspective, the integrity of the claims definitions is important because any deviation from the policy conditions would not only set a precedent [LOL - he is living with issues and you are worried about precedents?!?] for the future but would necessitate us reverting to any policyholders who may have been in a similar situation to Mr Teoule in the past.