Discovery Health
Discovery (DH) Refusal to Pay Claims

On 03/03, I fell off my bike & landed face first on the tarmac resulting in severe abrasions to my face, the loss of 1 tooth & 2 others being damaged (and later removed in an op). I was rushed to Vincent Pallotti (VP), where the GP on duty there admitted me to the hospital & called the plastic & maxillofacial surgeons & ended up undergoing 2 procedures & leaving VP on 05/03.

I've since been trying to get DH to cover my claims, I've so far phoned 3 times to find out why my claims have not been covered & only learnt yesterday that apparently my surgeon needs to complete a PMA form - which apparently was sent through to the doc 3 times, which they did not receive. I am very frustrated as I was initially told it was an error, then told it would be looked into & I would be called back (I wasn't) & only yesterday, a month later, told a PMA form was required. I am now having to play the middleman to ensure that the PMA form reaches the surgeon, & ensure that it is returned to DH. Also I learnt that my VP bill was not covered this morning only by telephoning the hospital - when I asked DH, there was no record on the system.

This is not the level of service I expect when I'm recovering.

Company: Discovery Health
Country: South Africa
City: Cape Town

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