DISCOVERY says it plans to increase investment significantly in its strategic initiatives, with the bulk of the investment expected to be directed towards the launch of Discovery Bank. Bloomberg
Durban - A Durban businessman who was a chauffeur for international celebrities and can no longer do so because of his medical condition, is in a tug of war over a multi-million rand claim with his insurance company.

Discovery Life not only refused Arnold Singh’s more than R3 million compensation claim in December 2018, it also cancelled his policy of more than 10 years.

Singh, 42, who has transported the likes of the Kardashians, Alicia Keys, Nicky Minaj, Cyril Ramaphosa and British royalty, was accused of exaggerating his arthritis condition, which he denied.

He said Discovery had appointed doctors who made the arthritis diagnosis and he accepted their opinion. He also claimed Discovery illegally recorded photographic and video footage of his movements months after his claim was rejected.

Those were some of the issues he raised at the ombudsman for long-term insurance’s office, but the ombudsman ruled in the insurer’s favour recently.

After experiencing difficulty driving in 2016, Singh consulted a doctor who diagnosed arthritis.

His Discovery broker advised that being unable to work because of arthritis was covered in his policy. Therefore, he would be entitled to financial relief, after medical assessments.

A claim was filed in June 2017.

By then, Singh was being treated by a specialist rheumatologist who diagnosed psoriatic (inflammatory) arthritis. A more aggressive drug, Humira, was prescribed, which was approved by Discovery’s medical aid division.

Singh was already taking a cocktail of drugs for other medical conditions - diabetes, glaucoma and hypertension. The addition of Humira worsened his health, causing him to become incontinent.

In June 2018, a Discovery-endorsed rheumatologist opined that there was nothing seriously wrong with him. However, the doctor was willing to change his assessment if an ultrasound or X-ray showed he had inflammatory arthritis.

Discovery ordered a magnetic resonance imaging (MRI) scan. The consulting doctor found Singh had “multilevel facet arthropathy” which essentially confirmed his psoriatic arthritis condition.

He received written confirmation about the same from Discovery in August 2018 and was told that his claim was being considered.

While his condition could not be classified as a “severe disability”, Discovery ranked it as a “permanent disability”, impacting on his “daily living activities”. Discovery told Singh the next step was an occupational therapist examination.

Singh was off Humira at that time.

Discovery informed Singh in December 2018, based on the therapist’s findings, that it had rejected his claim and cancelled his policy because there was no medical evidence to support it.

In the email, Discovery said he needed to prove he was completely unable to drive because of the condition.

Discovery also indicated that its rejection was based on months of “surveillance” they had conducted, which provided video and photographic evidence showing Singh driving, walking and taking his child to school.

Discovery demanded the return of the partial payout of R300 000 he had received in lieu of his claim.

“Since I stopped Humira, I am able to perform some tasks, but not with the same capability,” Singh said.

He denied he submitted a false claim and challenged Discovery to file criminal charges accordingly against him. He said medical experts made conclusions about his condition, all he did was answer the questions.

He asked if Discovery had a court order and the required documentation for the surveillance, if not, it was a violation of his “sacrosanct” right to privacy.

Singh said: “At no stage did I intimate that I was disabled, this is a conclusion that you (Discovery) drew. I said I’m unable to perform my job as a chauffeur and tour operator because I was ‘prone to random attacks’.”

Attorney Shalen Naidoo, who represents Singh, said his client was disappointed with Discovery’s conduct and handling of the matter. “The next step is to approach the High Court and institute legal action for recovery.”

Discovery Life’s reputation manager, Shanti Aboobaker said Singh, via his claim, had indicated he was bedridden and his ability to perform daily functions was permanently and irreparably impacted to the point he could no longer work.

“However, medical evidence provided by an independent rheumtologist indicated that he does not suffer from inflammatory arthritis, which was corroborated by a forensic investigation, publicly available social media posts, as well as an MRI scan which showed none of the features of arthritis were present.

“Evidence was found that Singh provided false information to Discovery, by grossly exaggerating his claim, in a quality of life questionnaire.

“We can assure that investigations conducted by Discovery were fully in accordance with our legal and Constitutional obligations. 

“Fraud and abuse of claims is a widespread challenge in the insurance industry. Funds held by insurance companies are pooled funds, which the insurer holds for the benefit of its policyholders. These investigations are necessary to ensure that our policyholders, as a collective, are protected.”

Aboobaker confirmed the matter was reported to the police in October.

Sunday Tribune