The latest ruling follows a complaint that the company’s severe illness benefit advertisement is misleading.
The Complainant was diagnosed with Parkinson’s Disease in 2020, which was upgraded to a category “Disability A” illness in 2022. Once diagnosed, he received payment for his severe illness, as well as “Overhead Expenses Benefit” (“OEB”) cover, which was paid for two years.
When he then enquired whether a possible future diagnosis of Dementia would also be covered and compensated in terms of Severe Illness Benefits and Overheads Expenses Benefits, he was advised that the Advertiser would not pay for another Severe Illness Benefit if he were to develop Dementia later in life, as this was related to his current diagnosis of Parkinson’s Disease.
However, the Discovery advertisement states: “Claim more than once. Our Severe Illness Benefit includes the most extensive multiple claims facility in the market - allowing you to claim multiple times regardless of whether the dread diseases are related to the first claim or not.”
In contradiction to Discovery’s ad, the ARB found there were indeed circumstances in which policyholders would not be able to claim for a new dread disease diagnosis.
The advertising body found that the Discovery advert’s suggestion that the company would pay multiple claims for severe illnesses "regardless of whether the dread diseases are related to the first claim or not" was untrue given the policy's limitations.
Discovery pointed out that various disclaimers appear across its website and advertising, such as the disclaimer “Product rules, terms and conditions apply” at the bottom of the screen where the disputed claim appears. Additional disclaimers would be added to remind people to speak to a financial adviser, and that product rules, terms and conditions apply.
While the ARB accepted that no reasonable person would expect an insurer to simply pay compensation for any and every claim it receives, it said promising customers the ability to claim multiple times "regardless" of whether a new claim is related to a prior one contradicts any notion of this limitation.
What Discovery has pointed out is the ARB is not a medical schemes ombud.
“This is important to note because it contextualises the role of the ARB in this dispute. At best, the ARB can potentially find that the Advertiser’s advertising material is deceptive or otherwise misleading,” says the ARB statement.
“This does not, however, empower the ARB to force the Advertiser to pay any additional policy benefits or reimburse any funds to the Complainant.
It would only mean that the Advertiser would be required to withdraw and/or appropriately amend the relevant advertising. Having clarified this, the only remaining question is whether the advertising to which the Complainant has objected appears to contravene the Code of Advertising Practice,” it explains.
As such Discovery has been ordered to remove or amend an advertisement for its severe illness benefit.
“…As a consequence, the advertising in its current format, and more specifically, the invitation to “Claim more than once ... regardless of whether the dread diseases are related to the first claim or not” appear to convey a misleading impression in a manner that contravenes Clause 4.2.1 of Section II of the Code,’ says the ARB ruling.
This follows a complaint at the end of June that Discovery’s gap cover advert is misleading in that it did not more specifically clarify that there was a 12-month waiting period before the claimed maternity benefits kicked in, according to an ARB ruling dated 25 June.
The Instagram advert showed an excited young couple looking at their pregnancy test results. The caption read: "Free for 3 Months. Are you thinking of growing your family?"
The advert was accompanied by a call to action, "Get gap cover now. Get quote," with additional wording claiming that Discovery gap cover comes with extra maternity cover.
Discovery explained the process following the ad being viewed:
“a. Customer views the advert on Instagram.
b. Customer clicks on the “Get a Quote” call to action.
c. The customer is then directed to the “Get a Quote” landing page.
d. The customer receives a quote, and subsequently proceeds through the Discovery GAP Cover new business journey.
e. The customer would then have to accept the terms and conditions which reflects the waiting periods.”
However, despite customers having to accept the terms and conditions of the gap cover, which shows the waiting period, and the acknowledgement of the ARB that it is not unusual to refer customers to terms and conditions, especially when advertising space is limited, the ARB ruled that Discovery gap cover advert, implied that the product would be useful for families who had just found out about a pregnancy, something that was not the case with the advert in question.
The ARB ruling states, "The reality is that the couple depicted in the photograph would not be covered until well after this baby is born.”
The regulator added that the visual communication of the happy couple further aggravated Discovery's claim: "We've got you covered with extra maternity cover…"
The Directorate considers the Advertisements to be misleading and in contravention of Clause 4.2.1 of Section II of the Code.
"Accordingly, the Directorate is of the view that to present the advertisement as a gap cover specifically to cover extra maternity costs, and then to have a lengthy waiting period of 12 months and not include this limitation in the advertisement, is misleading.
“The advertiser is instructed to withdraw the advertisement offering maternity benefits on gap cover without clarifying that there is a 12-month waiting period."
