AfricaComplaints.com » Health & Medicine » Complaint / review: Discovery Health - Claim not paid | #307800

Discovery Health
Claim not paid

My wife had a GP visit on 18/12/2013 (Dr LC). Our Medical Savings account was exhausted. Discovery advertises to members that once medical savings are exhausted the Scheme will fund 6 GP visits for the year.

I submitted the claim the same day via email (18/12/2013) (ref no 3127758532). For some reason the claim was not found.

I resubmitted the claim in January 2014, and low and behold, Discovery has sneakily paid it from my 2014 medical savings instead of from the scheme, as they advertise.

The date of service was in 2013 so Discovery cannot use my 2014 MSA (even if the claim was somehow lost in December 2013).

Notwithstanding the semantics of when the claim was finally received, it seems very subversive of Discovery to pay claims from members own contributed savings for the following year when they advertise 6 GP visits covered by the scheme/year once savings for the prior year are exhausted.

Date:

Company: Discovery Health

Country: South Africa   City: National

Category: Health & Medicine

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