Zuko Komisa
- Discovery Health has cancelled demands for members to repay thousands of rand following a year-long claims processing error.
- The scheme will now absorb the full cost of the overpayments, which affected over 16,000 members across its premium plans during 2025.
- All previous deductions will be reversed, and members who already repaid the incorrectly processed funds will be issued full refunds.
Discovery Health Medical Scheme has performed a dramatic u-turn, confirming it will foot the bill for a claims processing error that led to widespread overpayments in 2025.
The scheme has scrapped its initial plan to claw back funds from members after a significant public backlash.
The administrative glitch occurred between January and December 2025, affecting how prescription and other benefit claims were calculated.
This caused approximately 16,507 members on Executive, Comprehensive, and Priority plans to reach their Above Threshold Benefit (ATB) limits prematurely, resulting in higher payouts than their policies allowed.
In early January, the insurer sparked outrage by notifying affected clients—some facing bills of tens of thousands of rand—that they would need to repay the excess.
However, Discovery Health CEO Dr Ron Whelan has now apologised, stating that the scheme will bear the costs to ensure fairness and “put members first.”
The scheme has confirmed that any deductions already made from Medical Savings Accounts will be reinstated, and members who have already settled their “debts” will receive full refunds.
While the error affected only a fraction of Discovery’s 2.7 million beneficiaries, the incident has prompted calls for stronger industry safeguards to protect consumers from systemic administrative failures.
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