Captain Fastbastard Mayhem

Hey, at least they don't #looklikeasession

nah, BMC also have an extra lower link, VPP / DW style

nope and nope. Still a strict single pivot design. Giant and others like it are a DW link design, which means there's an extra linkage between the front and rear triangle. TOTALLY different design altogether.

If they increase THAT requirement, I will be in die moer in

Ah, so not that great.

Hmmmmmmmmmmm

Wonder if this will be instituted on the Vitality page as well

bold: Yep. I use that as well. Underlined: Yep. Used that, too. That's standard practice though, even in the case of smoking - if you "forget" to tell them (any insurer) your additional premium would be deducted from the payout in the case of a claim the loading is essentially a geographical one. Very different to saying you're 100% admin and you actually drive a delivery van, and have a claim denied on that end (where occupational disability cover is not available)

THIS. Always, this. In this case, even though I have a different opinion of what may have occurred to get to the no claim side of things, I'd continue to fight for an approval and adherence to their end of the T's & C's/

Eish. Not cool, Rob. I have to ask, though - where is your broker in this? It's difficult cases like this that I would get involved in... There's a reason beyond "they don't want to pay" and you are entitled to know that reason. As for the syncing - again, I'm pretty darn sure that the system / relationship / process of syncing is inherently more complex than it seems from the outside.

I don't know the merits of your case, or the specific PMB requirements / coverage for that particular event, but I'm willing to bet that the PMB allocation for physio for that event is 12 sessions - not 20. And on PMB, they are BRUTAL in their adherence to terms and conditions. Any physio treatment is normally paid from MSA, so once those 12 had run out you would have been dipping into savings pretty darn fast. As for the ice pack - again, not sure, but it probably didn't have a NAPPI code, or wasn't submitted correctly, or something went wrong. But if it was as part of your hospital admission it should have been paid, unless it was one of those things that the doctor / hospital pushes through when it isn't necessary - there's a lot more of that than you may think. I'll agree that it's petty, but 1,000 petty items all add up to us being charged more. As for the "doctors opting out" - absolute twaddle. Specialists that were part of the Disco direct payment arrangement were contracted to charge a factor of the Discovery Health Rate, as set by Disco, to reduce their overheads and unpaid bills (under the guise that they'd have more certainty of payment and thus have to spend less time on following up on non-paying clients) - there are now MORE specialists on these payment arrangements than there were 2 years ago. There may be (are) doctors leaving and joining the payment arrangement, but only because they either want to charge more than Disco will cover through the arrangement, or the numbers don't work for them. Also - ALL specialists charge a multiple of the Discovery Health Rate, Momentum Health Rate, Fedhealth Rate and so on. All the med aid rates were loosely based on the now "illegal" NHRPL (national health reference price list) which USED to set an "acceptable" rate for pretty much every single item and procedure code in the medical fraternity, but now all the med aids set their own rates based on their buying power and negotiation power (momentum and disco both hold significant clout in driving down the cost of medical implements) Specialists routinely charge between 300% & 500% of "medical aid rates" - this does not change depending on which med aid you belong to, and they (specialists) can charge what they want. This is a problem you will find at any med aid, as even the top tier med aids only ever cover at 300% of the med aid rate - so even on the Executive plan (Disco's crazily expensive top tier plan) you won't have as much cover for specialists in hospital as you'd have with a coastal saver & gap cover combo. I'm not doubting your experience at all, it's just that you have most probably been spun a yarn or 2 from somewhere, and are placing the blame squarely at Discovery's feet as a result of a bit of misinformation being pushed your way. I'm also not saying that you haven't fought them - for a claim to go smoothly, every single bit of info needs to be in the right place, at the right time, and done pristinely. Do you know if the physio has used the right ICD10 code for the work that he's doing, so that the sessions can be paid from the PMB benefit before shafting your savings? There are ICD10 codes that are to be used specifically for a PMB benefit. Also - it seems like you need to get a claims manager to talk to, in order to get the treatment you've been promised. Unfortunately, and I've seen this personally, sometimes it's the idiot behind the computer that doesn't put 2 & 2 together when receiving a statement or invoice from a hospital / service provider. Then the OTHER idiot who made the invoice up in the first place insists that they were right all along and it couldn't possibly have been their fault that they weren't paid... Through personal experience and handling claims, It's an admin nightmare trying to get the doctors rooms to submit the RIGHT paperwork, with the correct ICD10 codes with cogent motivations as to WHY they're doing something. Then to submit and follow up and and and. For a PMB event, it's even more time consuming and hair pulling. So much so that we have 2 employees in a 6 person practice (2 1/2 advisors - half because she's not actively practicing) that are solely devoted to dealing with med aids & gap cover and claims...

Nope, I need to know as much as possible. Helps me educate my clients...

Yep.

Not hard at all to understand, and you're right. I personally think it's a lot mor ecomplex than we think it is, though. Wish I knew more, or was told more...

I've been asked by my current boss / director man in the past whether I'd be prepared to go back to Disco, cos he got better service when I was looking after him. Only half jokingly...

That's purely due to people not knowing what they're covered for, I guarantee you. Every single report I've seen of that (also from my Disco days) is due to not understanding the levels of cover. EG: Having a Core plan and expecting coverage for dental procedures / investigative MRI scans etc...

LOL. Troll...

oh, the possibilities...

My broker consultant (the person who manages the relationship between me as a broker and Disco as a company) is utterly useless.

No, I get that - it's just that they ARE 5 separate companies, all under the umbrella of Discovery Holdings. Disco Vitality is a company Disco Life is a company Invest Insure Health... they're all run separately. Also - I'm not sure as to exactly how simple it actually is. If it were simple, and foolproof, the issues with syncing would have been ironed out by now. It seems as if there's a stumbling block SOMEWHERE, and I'd love to have a line to the VAR guys to see what that stumbling block actually is. The fact that it's intermittent is frustrating as heck as well. It may be the constant update nature of all the different devices (I get firmware updates on a regular basis on my garmin and connect updates and Discovery app updates) and whether that affects the communication pathways they put in place... I don't know. I'd love a bit more transparency on that issue, though. At least to know WHY it's happening, rather than just "get used to it, send us screenshots" But yeah - I know your perception is based on your interactions - but it's only interactions with a small segment of the Discovery stable. Does Vitality as a whole meet your expectations, whilst ignoring VAR? I'm sure the VAR team (which would be separate to the normal everyday Vitality team) are working feverishly to sort this mess out. Make no mistake, it's a ROYAL stuffup with all this intermittency... But it has nothing to do with the other aspects of their offering.

they need to do it so fast otherwise they lose out even more on track...

Have you been hitting it every week? Wait. No. Stupid question - I know you have...

It's a 12 week rolling history. So it increases or decreases based on your overall activity levels over that period, not just according to your last week's tally.

Rob, is that honestly a concern? The one is a contract between you and them that is reliant on your insurability, and once in place is there as long as you carry on paying the premiums, and as long as you were completely up front about your medical history, and is not subject to change unless you change it, or if there is a change in the claims criteria that results in more thorough coverage (if a change results in LESS thorough coverage, then it only applies to new entrants) The other is a points system reliant on the constant meshing of multiple systems and servers that occasionally (often) has bugs. What is evident is that even when it's working, it's not working for long - so there must be some sort of consistent bug in the code somewhere that results on something not being sent or read - the Life Assurance & Med Aid have sweet FA to do with that, apart from a Vitality Status perspective when it comes to your annual & 5-yearly paybacks, and your annual cover & premium increases. The points system has and always will be subject to change, and the new VAR system is subject to change as more data comes in. That was clear from the get-go. So - while their seeming incapability in providing a syncing system that works is a real concern on the VAR side of things, that should in no way detract from the quality of your actual life cover or med aid - as the 3 are completely separate.

Very VERY versatile tool. 3rd to my bosch gsb1080 drill & metabo sliding mitre saw it's my most used item.