'You owe the scheme'

BLUNDER: DISCOVERY MEMBERS ASKED TO REPAY AFTER CLAIMS ERROR

- Hilton Tarrant

NOTICE. Above-threshold benefits were paid even after limits were reached.

(Picture: Suren Naidoo/Moneyweb)

Discovery Health has sent communication to a number of members requesting them to repay Discovery Health Medical Scheme (DHMS) after a processing error saw claims incorrectly paid out at a higher rate than their plan's benefits allow.

The error is related to the Above Threshold Benefit (ATB) on the Executive, Classic Comprehensive, Classic Smart Comprehensive, Classic Priority and Essential Priority plans.

Day-to-day expenses are paid from the ATB once the member has reached their annual threshold.

However, the ATB itself has limits and when these were reached, Discovery Health paid for subsequent claims even though these claims should have either been paid from a member's medical savings account (MSA) or funded by the member.

Discovery Health won't disclose the number of impacted members or the quantum of the total amount owed but says a "small proportion of scheme members" and "only certain members" on the five plans were affected.