Fight over medical aid payout
A Ballito resident is still waiting for Discovery Health to cover the cost of a hospital stay she claims was medically necessary.

Ballito resident Sonja Whittacker (51) has locked horns with Discovery over their refusal to cover a day-and-a-half stay in the Netcare Alberlito Hospital intensive care unit.
After a seven month fight over a payout from her health insurance, it took a call from the media to get the health insurance company to change their tune.
In January Whittacker, a former physiotherapist, was rushed to Alberlito with severe nausea, headaches and diarrhoea. Since it was after hours, she was taken to the outpatient section and the doctor on duty diagnosed her with either encephalitis or
cerebral malaria.
“The doctor was concerned I may have been exposed to malaria during a trip to Mauritius in December and admitted me to ICU as a precaution. I was then placed in a general ward before being discharged. Tests confirmed I had encephalitis, not malaria,” she said.
Discovery apparently refused to foot the R 7610 for Whittacker’s stay in ICU because it was unnecessary, as encephalitis can be treated in a general ward.
“As a professional medical graduate I cannot agree with that. It is not possible to clinically differentiate between the two conditions.”
Whittacker said she did not hear from Discovery for months and settled the bill in the interim.
When Discovery received Whittacker’s test results in May she was told her application had been declined. However after The
Mercury published an article about Whittacker’s experience, Discovery contacted her for her proof of payment
so they could reimburse her.
“If I had not gone to the media nothing would have been done.”
Whittacker is still waiting for the money to be reimbursed.
“We get rewarded for being healthy but when you are ill and need your cover, you cannot get it.”