Discovery Health
Discovery Health Declines Claim- won't give reason

My wife was diagnosed with 3 hernias, necessitating surgery. This is a Prescribed Minimum Benefit stipulated by the National Department of Health that is mandatory for all medical schemes. Discovery however has chosen not to pay more than 70% of the claim of our surgeon and peddles in innuendo about the surgeon suggesting that he has committed medical aid. My requests - in writing - for the reasons for refusing to pay the claim have led to further ducking and diving by Discovery including being told that the only way I can get written reasons is to physically go to the Discovery office in Sandton. So I have a /- R50, 000 claim that I have had to pay and its almost six months later and 2 letters to Discovery later and still no written reasons unless I feel like spending a couple of hours driving to Sandton. Oddly, Discovery continues to take almost R8000, 00 per month from my account for my monthly fees, this they CAN do electronically. Unfortunately writing an email with their reasons for declining a Prescribed Minimum Benefit claim is too difficult. I guess transparency is not that important to Discovery.

Company: Discovery Health
Country: South Africa
City: Head Office

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