On the 1st of October our medical aid became active member number 409812270 and we received a medical aid certificate stating that fact with no waiting period.
On the 29th of December I got sick and was admitted to hospital for 7 days with this autharisation number 14467570 Discovery is refusing to pay and is saying this is pending.
On the 20th my partner took me to hospital in an emergency and I was immediately admitted and I was also in ICU. we paid R15 000 pending authorisation and after a day and a half Discovery refused to authorise I had to walk out of ICU pregnant with my low blood because I could no longer afford.
Their reason is that there is a 12 month waiting period for certain conditions. My argument is that they never informed me anywhere that there is a waiting period for certain conditions. My medical aid certificate stated clearly that there is no waiting period. I spoke to Samantha on the 30th/ 01 who said to me this is confidential and not communicated on company medical aids. Discovery is refusing to pay. Can they please settle this claim and reimburse our R15000 because it was an emergency and Discovery failed to inform us of this special waiting period.
0 comments