My wife and I had a baby, the final bill for the Gynecologist was R12500, Discovery paid R5527.80 as per the plan I am on. I submitted the shortfall to Essential Gap.
Essential have refused to pay the claim of the shortfall saying that I need to submit the shortfall to Discovery to come out of my prescribed minimum benefit, which is utter rubbish as Discovery have already paid their portion. I believe this is a delay tactic from Essential Gap. They never answer their emails, they never answer their phone.
I strongly suggest one never use their services. They are completely incompetent. Use somebody else.