How to let us know about your complaints and queries

Although we strive to give you excellent service, occasional errors still occur. We have a complaints process in place to help you get quick resolutions to your complaints and prompt answers to your questions.

Our complaints process

Call us on 0860 123 077 to speak to a service consultant and lodge your complaint. Please make sure you get a reference number from us. You can also email us at service@discovery.co.za. If you prefer email, it is important to use the word "Complaint" in the email's subject line. On average, we take one to two business days to reply if the enquiry or complaint is simple. If it is a complex case, we take around five business days.

Request an escalation

When you have received a response but feel that your enquiry or complaint was not dealt with to your satisfaction, or that the Scheme rules were not applied correctly, please contact us on 0860 123 077 or email us at service@discovery.co.za inserting the original reference number we gave you when the complaint was lodged with us. Ask to speak to the service consultant's team leader or a client relationship manager.

If a senior is not immediately available to take your call, the service consultant will confirm your contact details and make sure they contact you as soon as possible. Please make sure you always have your original reference number available to identify the date and the nature of the complaint reported to us.

Ask for help from the Principal Officer or Fund Manager

If you have already gone through the steps above but still feel your problem was not resolved to your satisfaction or that you have been treated unfairly in any way, please contact us on 0860 123 077 using the original reference number we gave you. Ask for your complaint to be directed to the office of the Fund Manager or the Principal Officer. The Principal Officer will review the complaint and either direct resolution to Discovery Health with an agreed turn-around time within which to resolve the complaint/escalation communicated to you. The Principal Officer may also direct your complaint to the Scheme's Disputes Committee to review your case. This depends on the nature of your complaint and whether the Principal Officer or Fund Manager can help you resolve the matter, without having to escalate it further. The Disputes Committee, if requested to review the complaint, will independently rule on the matter and check whether the Scheme has applied the rules, benefits and policies correctly.

What to do if you are still unsatisfied

If you are still unsatisfied, you can lodge a formal complaint with the Council for Medical Schemes (CMS). The Council for Medical Schemes is a statutory body established by the Medical Schemes Act (131 of 1998) to provide regulatory supervision of private health financing through medical schemes.

Complaints that have not been resolved through the Scheme's complaints and disputes process can be directed to CMS.

How to contact the CMS

The CMS official complaint form is also available on the CMS website. Go to www.medicalschemes.co.za > Consumer Assistance > The Complaints Procedure.