Discovery Health - You Pay us back for Our mistake.

neoprema

Executive Member
Joined
Jan 12, 2016
Messages
7,934
Anyone else got a letter recently (official) from Discovery Health saying they approved a claim for XYZ previously but picked up that they approved it by mistake and now want you to pay the money back?

Lol, have these corporates no shame?
 

JohnStarr

Executive Member
Joined
May 21, 2018
Messages
9,342
Anyone else got a letter recently (official) from Discovery Health saying they approved a claim for XYZ previously but picked up that they approved it by mistake and now want you to pay the money back?

Lol, have these corporates no shame?
...are you sure that's not a hoax? Haven't seen anything on my side.
 

neoprema

Executive Member
Joined
Jan 12, 2016
Messages
7,934
...are you sure that's not a hoax? Haven't seen anything on my side.
No looks real, came to my usual Discovery address:

Claims Payments

This letter is to notify you that Discovery Health Medical Scheme has reviewed your previous claims, in line with the benefit rules for medical scheme claims. Some of your previous claims payments are being amended under these rules.

Please refer to the attached letter for more information on your claims payments.

Regards

Dr Heather Rens
Discovery Health
Head of Clinical Care Integration
On behalf Discovery Health Medical Scheme
 

JohnStarr

Executive Member
Joined
May 21, 2018
Messages
9,342
No looks real, came to my usual Discovery address:

Claims Payments

This letter is to notify you that Discovery Health Medical Scheme has reviewed your previous claims, in line with the benefit rules for medical scheme claims. Some of your previous claims payments are being amended under these rules.

Please refer to the attached letter for more information on your claims payments.

Regards

Dr Heather Rens
Discovery Health
Head of Clinical Care Integration
On behalf Discovery Health Medical Scheme
I'd find out my legal rights around this then and tell them to get bent.
It's like an insurance company paying out for repairs to something, and then claiming that in terms of their newly updated scheme, it was incorrect and you need to pay the cash back.
Sure, by all means amend it going forwards, but not for something that was legal in the past!
 

bwana

MyBroadband
Super Moderator
Joined
Feb 23, 2005
Messages
85,510
Anyone else got a letter recently (official) from Discovery Health saying they approved a claim for XYZ previously but picked up that they approved it by mistake and now want you to pay the money back?

Lol, have these corporates no shame?
If the mistake was yours would you not want your money back?
 

neoprema

Executive Member
Joined
Jan 12, 2016
Messages
7,934
If the mistake was yours would you want your money back?
Probably, but that letter creates the impression they can change the rules and go back and claw back claims you submitted and they approved in the past?

They could come back to you for something they paid you 2 years ago now and ask for it back? For me its a small amount - what if they decide to ask you for the R100k they paid in hospital bills that their "amendments" now say should not have been paid?
 

3WA

Honorary Master
Joined
Sep 25, 2012
Messages
16,015
Probably, but that letter creates the impression they can change the rules and go back and claw back claims you submitted and they approved in the past?

So the claim was valid under the rules that existed at the time? If so, ask them to refund all your premiums for that year since you were paying for something that is different from what they sold you.
 

ShaunSA

Derailment Squad
Joined
Sep 7, 2005
Messages
42,112
Anyone else got a letter recently (official) from Discovery Health saying they approved a claim for XYZ previously but picked up that they approved it by mistake and now want you to pay the money back?

Lol, have these corporates no shame?

They're forcing all their staff to get vaxxed. Shame doesn't exist in their world.
 

Tomtomtom

Senior Member
Joined
May 6, 2010
Messages
881
So the claim was valid under the rules that existed at the time? If so, ask them to refund all your premiums for that year since you were paying for something that is different from what they sold you.

I think it's badly worded but the letter seems to be saying the payments are being amended, not the rules.
 
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