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Discovery Health Medical Aid
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1.4 210 Reviews

Discovery Health Medical Aid Complaints Summary

19 Resolved
191 Unresolved
Our verdict: If considering services from Discovery Health Medical Aid with a critical resolution rate, extra caution is advised. Examine detailed customer feedback to understand the severity and nature of unresolved issues. Be prepared for the possibility of unsatisfactory responses and have contingency plans, including seeking assistance from consumer advocacy groups if necessary.
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Discovery Health Medical Aid reviews & complaints 210

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Newest Discovery Health Medical Aid reviews & complaints

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11:23 am EDT
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Discovery Health Medical Aid misinformed

when my dad cancelled my moms medical aid after being on there all her life i was told to discovery, to my understanding there would not be a 3 month waiting period as she has always been on a medical aid. she is a cronic patient and is not able to get her medication. When i explained this to discovery they said sorry cant help, this is not service please can someone advice me on what i can do

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Ducky87
Portland, US
Jun 09, 2013 9:33 pm EDT

Don't know all details, but I'd contact her doctor. They should be able to push something through with medications that she needs to be on.

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2:54 pm EDT
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Discovery Health Medical Aid medical aid benefits

My child is hemiplegic and to improve her condition she has been receiving physio therapy and occupational therapy since 5 months old to help her cope with daily life. She goes for therapy once a week every month and because she needs special therapy she needs therapy to improve her condition for the rest of her life. We are on Discovery Health (South Africa) since 2012 and since then we have been trying to get approved funding for her sessions to be paid out of PMB and Discovery declines funding for my child from PMB. I have been through lengthy processes trying to get funding approved since 2012 but they keep declining. Discovery Health is a bad medical aid and a huge rip off. I am so disappointed and very unhappy with the processes that i had to go through and lengthy phone calls that never got resolved immediately to get approved PMB funding for my child's medical expenses for her therapy. I can relate to the many other complaints about Discovery Health from other people on this webiste and I can confirm that what they say is true. I can relate to the people that posted complaints on this webiste, their frustration and anger and their loss of hope with this medical aid scheme. I pay alot of money for my family to be covered but the benefits of this medical aid scheme is fruitless. I am considering another medical aid service provider. Dont use Discovery Health.

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pearlt
, ZA
Nov 26, 2013 11:34 pm EST

Claim rejected because of incompetant people at discovery and when resubmitting getting given a ref number that belongs to another patient. Kumaren and Rishana useless and do not assist at all. They rob peter to pay paul and don't give a [censored] about patients.

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11:25 pm EST
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Discovery Health Medical Aid overriding specialist diagnosis i

Discovery Health are refusing to authorize an admission into hospital despite the correct IC10 code and a letter of motivation by my daughters transplant physician when she needed to monitored for severe side affects related to her immune suppression therapy being reintroduced after a month of hospitalization with sepsis, bike duct surgery, UTI infection. She was discharged but had to be re admitted on 2 occasions as her reactions were so severe. As ONE of her many symptoms was a headache, the learned team at discovery - skilled at transplant medicine? NOT, have denied her Prof request to monitor her in house and treat her debilitating side affects beyond 24 hours of stay? Can a medical scheme play God like this, is our specialist then a fraudster in their eyes as are we? Is there no legal framework that given a specialists letters plus correct codes the validation to treat or does a team of amateurs dictate how severe things are and once again play "God" with someone's health.

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11:46 pm EDT
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Discovery Health Medical Aid refusing to cover for operation

i have developed an ingrow toenails medically known as onychocryptosis and has recently developed infection and it is painful and swelling to extend that i cannot wear closed shoes anymore. my GP referred me to a Orthopaedic surgeon because he doesn't have facilities to remove the nails. i received authorisation to see the specialist and the he said my nails should be removed so they can grow normal again. i was denied authorisation to be operated by discovery, they say they do not cover for this. i mean this is not me wanting to trim my nails or anything, i am in pain and cannot put on closed shoes in this winter, yet they don't care. i send them an email but nobody wants to respond. this is a matter of urgency. then i tried to make it better that if i can pay the doctors will the atleast pay for the hospital for those few hours that i will be doing the operation, No they don't care

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Anzett
, ZA
Nov 12, 2013 1:24 am EST
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No Service at all. Deducted wrong premium, all proof already mailed and telephonically explained more than 3 times. Noboby getting back to us. Nobody helping us

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4:28 am EDT
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Discovery Health Medical Aid claims not being settled to member

I am a disabled female and am reliant on my medical service operator. I had claim for a much needed mobility scooter in 2011. My claim was appproved after the required documentation was submitted. The product is imported from sweden and only got delivered in 2012. The South African supplier requested a deposit so an order could be placed for the product, once the product got delivered the balance got paid, I kept no funds and the supplier received the full payment. Discovery Health are now accusing me of fraud, causing a over claim for 2012 as they have processed the claim as a 2012 claim although it was approved in 2011 and all my other claims are not being paid to me. NOBODY HAS THE SENSE TO UNDERSTAND and there forensics person Mrs S van Rooyen is extremely rude and ARROGANT, I need my claims paid to me and not be stuck between the two parties. Why am I involved? Why does discovery health not pay the supplier directly instead of involving the member? My claims are not for external medical apparatus but are being treated as if they belong together. I just need someone with sense!

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3:21 am EDT
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Discovery Health Medical Aid keycare benefit option is rubbish

Don't be fooled by Disovery Health and their Keycare benefit option. This medical aid plan hardly pays for any medicines (as prescribed by a rather small medicine formulary) and procedures. The only thing they will pay for is a doctor's consultation...I'm too scared to think of what will happen if I have to go to the dentist. Be careful...I didn't claim from my Keycare benefit for an entire year and this year (2012) when I got bronchitis and eczema, the medical aid refused to pay for all four medicines that I was prescribed by a keycare (designated service provider) doctor/general practitioner that I am compelled to visit, due to my medical aid plan. I have sat the entire day fighting with the unfairness of a medical aid to which I religiously pay my monthly contributions (on time, evenry month) and yet they decide to NOT pay for a medicine claim that came to R115.63. Be vigilant, be careful as to how you will go about choosing your medical aid and cover and what you are entitled to vs what you originally thought. They have also changed the medicine formulary for 2012 and have taken off a number of medicines (common, vital medicines, including antibiotics) which are necessary and commonly prescribed forms of medicine to patients with common conditions such as colds and flu. Be careful and take care, stay healthy, choose wisely

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Maggie Booysen
, US
Jul 12, 2019 5:46 am EDT

Try getting pregnant and not having the benefit of giving labour in a private hospital. I have been asked to do a scan by our GP - and GP's don't do scans. GP referred me to the Gynae (which is on our panel) and I had to pay for the urine tests, scans - everything. Even Gynae visit.
It would have been better going to Karl Bremer for labour. I am still pregnant and stressed out. I do not know whether this medical aid will cover the birth of my unborn child.
I was given the option to going to Government hospital.

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abdulqaadir essa
, US
Jun 20, 2018 5:56 pm EDT

I am rather impatiently waiting for someone who has a vestige of Client Interaction to call me from Key Care Plus, and I will then separate the men from the boys!

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2:14 pm EST
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Discovery Health Medical Aid discovery health medical aid

I have changed jobs so my memberships also changed with discovery. There whas savings left on my MSA and I thought well if there is something coming throught late it will be covered. Now in FEB I get an sms stating im being blacklisted for R350.00.
I havent received letters, phone calls or anything. The adress they have is older than 2 years. My cellphone number is still the same. How could they sms but not get hold off me trying to phone or leave a message. They also have my new details, company number, email ets, they could contact me there. But no, the rather dont do their jobs and get me blacklisted for being USELESSSSSS. I feel this is unfair. I always pay my accounts on time, and have debit orders. Now my whole credit record is ruined.
And there is probably nothing I can do. Im being blacklisted so why pay this then hey?

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2:00 pm EST
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Discovery Health Medical Aid non payment for chronic medication.

Even after numerous requests as well as a letter from my Neurologist requesting and warning that I cannot use Generic versions of the Medication I needed, Discovery blatantly ignored our requests and still did not pay for or refund the Chronic Medication (even though they are bound by South African Law to cover Chronic Medication) I needed because I didn’t use the Generic version. The Medication I use is for Epilepsy and the Seizures come with no warning and can be Fatal. Due to Discoveries dangerous apathetic attitude I was forced into a bad financial position as well a dangerous medical position and I am now out of pocket by thousands of Rands. It makes me wonder how many other people are being put in dangerous health situations and being ripped off by Discovery Health. I have been trying to get Discovery through various departments to come to the table for over a year now. I would like to know where is my refund and don`t tell this matter is closed like you continue to do because it isn`t and never will until I am refunded.

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3:35 pm EST
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Discovery Health Medical Aid debt collection

Good day
My name is nancy both.
I had a medical aid (Forced by the company) with discovery. I was in hospital with internal bleeding in my lung!
On the reception in sunning hill hospital, I have spoken to discovery myself (July 2011) numerous times making sure all procedures are covered, and was told that the mri and ct same as the heart scan are fully covered that was confirmed by a consultant! Their calls are being recorded but discovery refuses to let me listen to the calls!
As I finally came out of hospital I lost my job, which meant I had to cancel my discovery. Then I was informed that the savings account was used when I was admitted to hospital, which is wrong according to their promises! About 3 months thereafter I started receiving bills from doctors saying I owe them money. How can that be, as I was fully covered and admitted to hospital, on a comprehensive plan?
So I have paid some of those bills (added up to over 1000 rand). Finally (I thought) then I received a bill from discovery saying I owe r2300.00! I have sent numerouse e-mails enquiring on where I owe the money, and I have been told that my savings account was use while I was admitted. However when I joined the medical aid I choose it, because discovery clearly stated that if you admitted to hospital no savings account will be used!
I have sent more than one fax, calls, e-mail asking for settlement, no answer was received from discovery!
Now I have been handed over to their debt collection. The debt collectors only sent sms, and if they call they do not provide a company name, nor a name of who you speak to!
I have been threatened to get deported, someone will come and get the money, they come to my house ect.
I have spoken to them today [protected]) and requested a letter sent via post - i’ve been told not to be difficult, if not they will come and get the money! I mean really now? I’m not going to pay one who sends me a sms wanting money? No company name? No letter no nothing just a call from a random person?
Please someone help me, because that is a scam! And I will not pay, until I get the recording from the calls, and a detailed statement! And I will not pay legal fees, because I made contact!

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Mowbeth
, ZA
Jan 27, 2017 3:23 am EST
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I went through the same thing in terms of having to pays doctors separately and then Discovery as well- which is absurd. Never the less after making full payment to their dept department, they still send me statements without ANY explanation. They hide behind no-reply emails which doesn't even explain the reason for their incompetence. Discovery doesn't ever apologize to law abiding citizens or take OWNERSHIP of their mistakes as if they are above the law?! As for emails, it's blankly ignored. Makes me wonder if this "we don't give a #### about you attitude" runs from the CEO down? If so, then well done as Discovery's customer service goes down the toilet.

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7:08 am EDT
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Discovery Health Medical Aid stealing money from my account

My membership Number with Discovery is: [protected]

I am on key care plan with Discovery Health because I do not have work as a result of my illness which affects my mental state negatively and is aggravated when I get stressed out. I suffer from front lobe epilepsy and cannot hold a job now for over 5 years. My problem is that Discovery keeps on nagging through their call centre pestering me about my income status a number of times a year. They call me on my cell phone (I dread talking on cell phones as I believe it makes my condition worse)and interrogate me for long periods to find out if my status has changed. I keep on telling them that I am getting more sick because the nature of my illness is as such; but they do not back off and keep on and on and on to irritate the living daylights out of me. Now I notice that they have put my premium up to maximum without even as much as a letter of explanation why they did that. I did tell the lady from the call centre that my status as an income earner has not changed and that Discovery does not even want to pay for my chronic medicine and that I have to go to the state hospital monthly to get my epilim and that by itself is a big challenge. I am very upset because I am living off the proceeds of a property of mine that I was forced to sell a number of years ago in order to make ends meet and now Discovery is ciphering the last little bit of savings that I still have left. Please give me some advice on what I can do to this company that keeps on bullying me like this. My brain is not working well for a number of years now and Discovery Health is actually making it worse by traumatising me continuously. I think it is disgusting of them that they blatantly went and put my premium up to maximum because a call centre employee of theirs didn't like my attitude. Who can blame me when this company teaches their call centre people to terrorize people like myself who have a disability? I have given them proof of all they asked for in the beginning and they still keep on and on and on with their nagging irritations. I hardly ever go to a doctor. The only reason I want this cover is so I do not end up in a state hospital if I happen to be in an accident. My record will show that I see a doctor perhaps once or twice a year; yet they bombard me with stupid and irritating questions. They make me very ill with their terrorizing tactics?

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8:07 pm EDT
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Discovery Health Medical Aid undue enrichment

I joined Discovery for the second time in April this year (2011) and the first premium of R445.00 was debited from my bank account ahich was to cover me for the month of May 2011. I visited the doctor twice in May and due to a technical error, my plan was cencelled by Discovery. I was told that since I was not entitled to be covered, I would be reimbursed whatever was due to me after the Doctor whom I visited was paid. Discovery then debited my account for a further R890.00 at the end May 2011 after the cover was cancelled. I then received a call from the Doctor telling me that Discovery was refusing to pay them because my cover was cancelled.
It is now already almost the end of June and I still didnt receive any reimbursement of any monies that was taken by Discovery. It is unfair that Discovery should have taken so much of my money and refuses to pay the Doctor's fees which is only R300.00 from what the Doctor tells me.
Discovery was so quick to cancel my medical aid due to a minor mistake but they are sure to take money that do not belong to them.
Imagine doing this to a good few poeple?
Discovery is just getting rich by stealing from the poor.
I wouldlike my money returned to me and if Discovery does not want to pay the Doctor, then they must return the entire amount and I can then pay the Doctor myself.
It is really tough and I chose to take medical aid so that I can have peace of mind in case I need medical care.

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1:47 am EDT
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Discovery Health Medical Aid avoid this company like a disease

Discovery in all of its alleged polished marketing glory is the biggest scam being perpetuated in South Africa. They have zero credibility when it comes to doing what they are contractually obligated to do!

Don't believe me ... seriously read the blog at http://www.discoveryscam.com and you'll know that this company is absolutley without a doubt a CROCK!

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2:28 pm EDT
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Discovery Health Medical Aid chronic illness application

Dear Discovery,

I am basically on my knees with tears in my eyes. My daughter has got a rare life threatning disease and Discovery keeps on shooting down for us to take out Chronic Illness Benefit for her. She was diagnosed with this disease at the age of 4 months. She is now 2 yrs and 4 months almost and still i cannot get her approved for Chronic Illness. Her Pediatrician (Dr HP Van Der Merwe) has also send motivational letters to confirm this. Her diagnostic code is: IDC-9-CM Diagnosis Code 255.13. Please i am pleading with you. We pay an enormous amount every month on medical bills and we pay our discovery plan every month, but Discovery does not want to assist in this. This is a life long illness, it will never be fixed, unless God steps in and make her healthy again. I have had no help from the staff at Discovery, they keep on putting me through to different people and no one is willing to help me. Can someone please see this as urgent and help and make our families life a little bit easier than to sit and worry every month if we are going to have money to buy her her medication. This is a rare disease, but becoming more common. I feel that discovery should put this on there list of cronic illnessess, it will help allot of people. Please Please i am begging someone to assist me and help me ! Worried parent - attached is a photo of my daughter - please help and make her life easier especially for when she gets older.
kind Regards - Nicolette De Candia - Paarl South Africa

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5:01 pm EST

Discovery Health Medical Aid due to incompetence a member has to pay the price

I requested an upgrade on my membership in December, but it was never done. I have logged several calls and sent a number of emails yet to no avail. I then in January 2010 approach our Company Broker (Samantha) to assist me as I have had no joy from Discovery regarding my upgrade. (I’m employed with NUS Consulting). I then left it in her capable hands to follow up and resolve them matter. She requested my membership number, which I provided. I once again left it at that and awaited confirmation that I was now upgraded. I even submitted a claim in the month of February March’ 10, which to my dismay was rejected. I queried this and realized that I am still on the hospital plan with Discovery and was never upgraded, only realizing that the Company broker had also not done what I requested. As we are subsidized by the firm I therefore did not bother to follow up on this, as one would assume that once employed with a firm all would be covered under one. No one from Discovery had taken the time to contact me, as they apparently left A MESSAGE for me to call? I all of a sudden rec a email re client services re a call logged, which the broker did? Why was this not the case in DecJan?

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10:46 am EST
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Discovery Health Medical Aid premiums paid but medical aid cancelled

I was informed by discovery to pay R3000.00, i paid the R3000.00 as discussed with the consultant. this was during the course of september 2010. I poske to discovery consultants again during december where i was informed that everything was fine and i paid in whatever was still required in December. Yesterday i was informed that my policy has been cancelled since september 2009 because of a short payment of R122.00. i spoke to the consultant yesteday and informed him that why in the world would i pay R122.00 short if i paid R3000.00 on the same day. Now they tell me of of a declaration of health form i am supposed to have sent to them in September, which i donot know about. I asked them to check the recording of when the consultant called and told us that we should pay in R3000.00 and now they cannot find the recording. I cannot remember the consultants name or the date exactly when they called, and i dont think any one can remember the date and times or even names of consultants that call them. I know sit in a position wherby myself and my family donot have medical aid active because of a consultants error in not telling me to deposit R122.00. This is totally ridiculous...

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7:49 pm EST

Discovery Health Medical Aid cannot resolve even a simple query

I have a very simple query that Discovery needs to resolve. But clearly this is too complex a task for them. This query has been going on for 3 months now. Each time I speak to an agent, they tell me my complaint has been resolved and that all is in order. Till next month, when I get a letter from them again about the same thing. I called Friday afternoon after receiving the same letter once again to speak to a manager, but of course, no managers work after 16h30. You cannot run a call centre without a manager? I called again on Saturday to get Mr A Gore's email address. Hoping he could sort out this 'complex' query, but was told by the agent that she would get fired for giving me his email address? I'm not asking for his personal bank account nr, just an email address. Clearly he does not care to be available to any client issues, I wonder if he has any clue what is going on in his call centre if you cannot get past the first agent that answers...Well after this, I had no choice but to go to the Council for Medical Schemes, seen as I'm not allowed to even send an email to the CEO.

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Maria Spencer
, ZA
Mar 12, 2013 7:54 am EDT

PHONING PHONING PHONING !B GETTING NO WHERE AT ALL

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7:38 pm EST

Discovery Health Medical Aid authorized specialist visit not paid for

A staff member of mine is on Keycare Plus. She needed to see a specialist and her GP referred her, sent the forms to Discovery and we got an sms with an authorisation number [protected] from Discovery. She then visited the specialist and now we get an email saying the specialist will not be paid. Reason: 'Your specialist visit hasn't been paid as you or your chosen GP didn't get a reference number for the visit...' Why have a medical aid, go through the correct channels, get an authorisation, only to be told you haven't got authorisation. In addition to this, the specialist actually needs to operate, and his office got an authorisation from Discovery for an op, and we have already done pre-admission. Do I have to assume that after the op, we will be told that we need to settle the bill as we had no authorisation? I thought Discovery was founded on the principal of sound administration, claiming superior claims administration compared to other schemes. They do not live up to that anymore. What is happening? I do not have time to waste when we have done everything we needed to do from our side following onerous procedures to ensure we get the service we are paying for!

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8:37 pm EST

Discovery Health Medical Aid discovery did not cover hospital bills as promise

Once again, Discovery did it. I am still shocked by the promise made by discovery prior the birth of the baby. I specially made an enquiry a month before my date of delivery, enquiring about the bills for maternity hospitalisation so I can keep some extra cash for the bills but they said there is no need to worry as everything is approved and they will cover everything from birth day but to my surprised I have received a bill that states that I need to pay 5290.00.Discovery will only pay 2300 and I should pay the reminder of 3000

I called the call centre and they said the reason was the specialist did not charge according to their scheme rate but the specialist is within their network and i have been with the specialist since January, nobody told me that there will be a problem afterwards which I clearly do not understand more especially after all the approval they gave me.

Please assist, this is uncalled for, now we have to pay the bill that is not planned, Discovery can I please enjoy my bundle of joy without demanding any payments from us, This should be the happier times. What about the 710.00for the date of 10 March 2010.Are they going to pay or not.

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5:37 pm EST

Discovery Health Medical Aid appalling service from all staff

I would like to inform you of the terrible service that I recieved from the Call centre agents, their supervisors and the manager in the department at Discovery. I have cancelled my Medical aid and requested my savings portion to be paid out into my banking account. The first agent I spoke to was very polite and told me that the funds had been released however my banking account was closed. I was advised to complete a change of bank detail form. I decided to call my bank only to find out the account was still active so I called Discovery back. I spoke to the rudest man, Lebo, who told me with a very appaling attitude that it's my fault because the 5 in my bank details looks like a 6! I asked to speak to a higher authority and spoke to the Relationship Manager Charmain Erasmus who gave me the exact same story so I asked for the Manager, Jannie van Niekerk. He was just as rude, he never listened to a word I said, spoke over me the whole time and basically did nothing to resolve the matter. I am still waiting for my cash refund and have never dealt with such incompetent, rude people in my life. When Managers deliver poor service you have to wonder about the staff they manage!

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5:40 pm EST

Discovery Health Medical Aid ignoring my application of dependent

I submitted my application form to add my daughter to my Mdical aid on 8 December 2009. I received and reference number back to confirm that the email and application was received. I then needed to get her vacinations done and discovered that my daughter was not added to my Medical aid. 3 months later, Nothing has been done about the application form that I sent in! I then called in on 3 March 2010 to follow up and resend my application form and still NOTHING has been done. My daughter still does not exsist on my Medical Aid.

I have spoken to a numerious amount of staff at Discovery Health and no one has bothered to call me to inform me what there delays are and if there are any problems. I have had to call in everyday to follow up on this and still NOTHING has been done.

If anything had to happen to my daughter she would not be covered as Discovery Health can not do their jobs!
I think this response and Discovery Health's service is shocking!

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Phone numbers

+27 115 292 888 +27 315 086 444 More phone numbers

Website

www.discovery.co.za

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