Response to article published on 28 January 2014 in Business Day ‘Accusations fly in medical aid case’

Response to article published on 28 January 2014 in Business Day ‘Accusations fly in medical aid case’

SIR – Your article on the legal case against road accident fund attorney Ronald Bobroff, creates an inaccurate picture of how Discovery Health Medical Scheme members are covered for road accidents, suggesting that the Scheme denies cover for members involved in any accident (Accusations fly in medical aid case, 28 January). One of the biggest medical and health concerns consumers have is whether they will have the necessary medical cover should they be involved in a road accident, and Discovery Health Medical Scheme places the highest priority on ensuring that members have immediate medical care and treatment after an accident. Every Discovery Health Medical Scheme member has full cover for claims related to a medical emergency, including road accidents – no questions asked. Hospital authorisations are issued immediately to ensure that there is no delay in patients getting the appropriate and necessary medical attention. In the case of a road accident, members of Discovery Health Medical Scheme, like any other South African citizen, do have the right to claim for their medical expenses from the Road Accident Fund. However, Discovery Health Medical Scheme never forces members to institute claims against the Road Accident Fund. In instances where members are refunded from the Road Accident Fund for their claims, and where the Scheme has already paid for those claims, members are required to refund the Scheme. Allegations that Discovery Health Medical Scheme forces members to claim from the Road Accident Fund, or that it does not cover road accidents and emergencies are thus entirely wrong, and our members can rest assured that they have the full hospital cover in all of these situations.

Milton Streak, Principal Officer, Discovery Health Medical Scheme and Dr Jonathan Broomberg CEO, Discovery Health