Discovery Health
Failure to settle valid in-hospital claim

Our baby was born two months premature on the 17/09/2012. At birth he developed a severe fungal infection which the Pediatrician (Paed) treated with Ambisome. A letter of motivation (LOM) was 1st written by the Paed on the 09/10/2012. Discovery did not want to pay for this claim and requested further information from the Paed. A 2nd LOM and lab results were sent to Discovery on the 23/02/2013 and 13/03/2013 respectively. On receipt on this information Discovery was expected to pay for the claim. However Discovery rejected the claim and say they are awaiting further information from the Paed. According to the Paed there is no further information that can be submitted as what has been sent is conclusive.

I can't understand why Discovery is delaying the process and not settling the account. We have now received final notice warnings from the hospital who are holding us liable for account settlement. Please can Discovery urgently look into and resolve this matter and stop going around in circles. This is very unprofessional behavior for a large company like Discovery. We are Classic Comprehensive members and pay a substantial amount for our cover and expect to get what we pay for.

Company: Discovery Health
Country: South Africa
City: Sandton

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