Discovery clients hit brick wall with medical claims, after firm says it won’t pay

Kayla Hammond after her operation. Picture supplied

Kayla Hammond after her operation. Picture supplied

Published May 30, 2022


Cape Town - Kayla Hammond and Lood White are two angry and frustrated clients of Discovery Life who claim that the insurance giant has treated them badly by not paying out their medical claims despite their having diligently kept up their premiums, even through financial hardship.

For many people insurance is a grudge purchase as they feel they are paying for something they hope and expect will never be needed.

In their separate cases, Hammond and White expected to be covered but suffered a rude shock when they realised that their insurer was not going to pay up.

Hammond said she told Discovery Life that she was born with a clubfoot, but when her foot had to be amputated for medical reasons she claimed from Discovery and the claim was declined.

Though Discovery Life told her that the non-payment was due to non disclosure, Hammond vehemently disagrees and insists she was completely truthful.

“Discovery was incompetent from the onset of my application. I have always been honest and transparent in my applications.”

She now says that she is in debt for medical costs and she is struggling because her condition needs special attention. She said Discovery Life owes her R2 million for her cover.

Kayla Hammond after her operation. Picture supplied

Hammond escalated the rejection of her claim to the Ombudsman for Long Term Insurance’s office, twice, leading to two separate and independent investigations but on both occasions, Discovery Life’s repudiation was upheld.

In the meantime, she has started what she calls an awareness campaign about Discovery by sharing her story with the public via videos and posts on YouTube.

Meanwhile, Lood White took out life cover with Discovery Life in 1998. In April 2017 he was diagnosed with a major depressive disorder. He submitted a disability claim to Discovery Life after being advised that he had disability cover.

“Discovery requested financial statements and IT34s – I supplied all the requested documentation and Discovery Life’s actuary department confirmed my income loss was greater than 80%.”

Lood White. Picture supplied from Facebook

White said that his claim was approved and the first payment of 2.5% was made in January 2019. Four months later the other 2.5% was due but this payment never materialised.

He said this is a breach of contract and that he is still waiting for his matter to be settled.

Reached for comment on the two cases, Discovery Life head of legal Hein Human said it sympathised with Hammond, who he said was a former client.

“Unfortunately, it was found that she grossly misrepresented the true circumstances surrounding her medical history when she took out her Discovery Life policy in October 2019.”

Human said Hammond disclosed her clubfoot condition in her application, but she neglected to tell Discovery Life about the severity of her condition.

As for White, Human said he had provided false information materially exaggerating his medical condition to unduly gain from his insurance policy.

He said that White had since issued a court summons against Discovery Life in the Western Cape High Court and that litigation is ongoing.

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Cape Argus