I was in hospital in March 2013. Most of the bills had been paid. On Friday 6 Decber 2013 (9 months later), we receive a claims notification from Discovery that the claim for Mauff A C And Partners was actually reversed. It is sad to note that medical aids are too happy to take your money but when it comes to paying claims, they will find any excuse not to pay the claims. Upon calling the call centre to query this, they state that the claim was reversed because it was for Stem cells and they do not cover this. This was a in hospital claim and should have been paid by Discovery. Needless to say reversing something 9 months later - I do not see this as very proffessional or ethical. What rights do we have as members? Can Medical Aid companies do whatever they please? I feel that we have been penalised for this now and our account will now reflect badly at Mauff A C And Partners. Discovery should take the loss for this and not the member. Legally - is this allowed? We normally have 3 days to query something, but Discovery takes a whole 9 months and gets away with this.
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