Ulcerative Colitis Claim against Discovery Life Policy
I took out a Life cover benefit in 2009 with Discovery Life, I feel ill in 2015 and was diagnosed with an illness which forms part of my Life cover benefit. I lodged a few claims against by Life benefit and after 2 declined applications, I was eventually settled 2 claims on a different part of my benefit cover (Disability benefit). I subsequently lodged another claim against my life cover, only to be told by the Ombudsman for Long Term Insurance and Discovery Life, they both confirmed and agree with my illness however it does not form part of the illnesses covered by the policy and the insurer is not obligated to pay a claim for this condition. When one has to assess their Severity levels documented and which supposedly forms part of there assessment of claims, strangely my Illness is considered a Severity Level C with a LifeTime impact Score of 11. How does one pay for a policy for over 12 years only to be told now at a time of need that your illness is not fully covered. Surely this is unfair practice by the Insurer and which renders the consumer incorrect information about the type of cover they are paying for monthly.
Kindly note that this matter will be escalated to our Claims Management team for their investigation and feedback directly to you.
Regards
Habibah
DISCOVERY LIFE
Kindly note that this matter will be escalated to our Claims Management team for their investigation and feedback directly to you.
Regards
Habibah
DISCOVERY LIFE
"To qualify for a claim under the Severe Illness Benefit a total colectomy is required. We have previously informed you that Discovery will not force any person to undergo surgery to prove a claim. This decision lies with you and your medical practitioner. We will only be in a position to consider a Severe Illness claim once the critiera of the Severe Illness Gastrointestinal Benefit is met."
Note the undertone of being suggestive of how bad this illness has to be in order to "possibly" meet the minimum criteria on a successful claim being lodged on this illness benefit. Noting my medical history thus far (as my Medical Aid is with Discovery and linked!) and my challenges with this illness over the past 7 years, surely there is some grounds of human compassion when claims of this nature are evaluated, not forgetting the lives affected by these decisions. Don't get me wrong, Discovery Life has awarded me 2 claims under a different benefit 2 years ago, however choose to not recognize this illness at all until a Colectomy is done as evidence in this claim. Truly shocking to learn this after 156 monthly premiums and 8 months of waiting for an outcome on the claim. Truly shocking....
"To qualify for a claim under the Severe Illness Benefit a total colectomy is required. We have previously informed you that Discovery will not force any person to undergo surgery to prove a claim. This decision lies with you and your medical practitioner. We will only be in a position to consider a Severe Illness claim once the critiera of the Severe Illness Gastrointestinal Benefit is met."
Note the undertone of being suggestive of how bad this illness has to be in order to "possibly" meet the minimum criteria on a successful claim being lodged on this illness benefit. Noting my medical history thus far (as my Medical Aid is with Discovery and linked!) and my challenges with this illness over the past 7 years, surely there is some grounds of human compassion when claims of this nature are evaluated, not forgetting the lives affected by these decisions. Don't get me wrong, Discovery Life has awarded me 2 claims under a different benefit 2 years ago, however choose to not recognize this illness at all until a Colectomy is done as evidence in this claim. Truly shocking to learn this after 156 monthly premiums and 8 months of waiting for an outcome on the claim. Truly shocking....