Claiming made easy


Claim like a pro

Claiming doesn’t have to be a hassle. It is important to always keep track of your benefit limits to ensure you have funds to cover your claims, as well to submit your claim within four months of treatment.

How to send us your claim

LA Health usually settles claims directly with healthcare providers at the LA Health Rate for your benefit option. However, there are cases where you will have to submit the claim yourself. Here’s what you need to do to claim successfully:

  • Claims must be submitted within four months. Older claims will be considered expired and will not be paid. This is according to the Medical Schemes Act.
  • Know your benefit limits so you can be certain of cover.
  • If a healthcare provider charges more than the LA Health Rate, you will have to settle the balance with the healthcare provider.
  • Make sure that your membership number, the healthcare professional’s details including the practice number are clear on the claim.
  • Send a detailed claim and not just a receipt, as we need the details of what you are claiming for in order to process your claim quickly and correctly.
  • Keep a copy of your claim for personal reference.

Where to send your claim

There are a number of ways for you to send your claims to us. These include:

  1. Email: Send your claim by email to claims@discovery.co.za
  2. Fax: Send your claim by fax to 0860 329 252.
  3. Claims drop-off boxes: Drop your claim off at Discovery Health’s offices or Discovery Health claims box. You can find these boxes at Virgin Active or Planet Fitness gyms, Dis-Chem pharmacies, and most medical practices.
  4. Post: Post your claim to: PO Box 652509, Benmore 2010 or Postnet Suite 116, Private Bag X19, Milnerton 7435.

Remember

If you want a claim to be paid against your current year’s benefits (2017) then such a claim should not have been submitted for payment in the previous benefit year (2016). Such a claim will only pay against your current year’s benefits provided it is not a stale claim (i.e older than 4 months from the date of service).  A rejected claim or a claim that has only been partially paid in the previous year (2016) can also not be resubmitted in the new benefit year (2017).