Members of Discovery Health Medical Scheme blame the scheme of being "tone-deaf" and lacking accountability regarding administrative failures.
This follows the scheme’s decision that about 16 000 of its members must repay money due to a financial system error that led to incorrect payment of medicine claims.
The error totals nearly R5,800 per member over 12 months.
Critics argue that since the administrator failed in its primary duty to process claims correctly, it should bear a portion of the financial burden.
Plans affected by the error include Executive, Classic Comprehensive, Classic Smart Comprehensive, Classic Priority, and Essential Priority.
“Records used for the recovery letters were dated 18 December 2025, suggesting a frantic reprocessing period during the festive season. There is no current mechanism for the scheme to penalise the administrator for this failure. This has led to calls for a review of the ‘watertight’ contracts between schemes and their administrators, which often seem to absolve the latter of financial responsibility for systemic failures.”