Breach of contract stay far away!!!

I signed up with affinity health in August 2017

My family (3) n I

Monday 6th April 2020 is when we submitted our first claim for a colonoscopy to be done on my wife which followed with a CT scan, They paid part of the CT scan (R10000) n I had to pay the balance of R6000

Further more Upon findings, it’s confirmed that my wife has a cancerous tumor in her colon and part of her colon will need to be removed to be cured.

I contacted affinity health and provided them with the quotes they required. When I called them to find out if they received the quotes I was told that an “amendment to the policy was made in 2020” n they no longer cover dread diseases upto R20000 n now they refer to it as severe illness shortfall??? N.B I was not informed or told of such as our contract in 2017 stated upto R200000 will be covered for dread diseases. Now they saying that they will only cover a percentage of the serverity of the cancer

Eg: stage 1 cancer 25% stage 2 cancer 50% n so on..

Nobody mentioned or called us to inform us that this is there new method of paying n assisting clients.

So basically they want my wife to sit at home so the nature of her disease can reach stage 4 in order for them to pay out the full claim.

At this stage we don’t know what stage it is as the procedure needs to be done and once the cancer is removed it will be sent for testing.

Now honestly as a client how am I suppose to move forward? The hospital quote is R149000 for the procedure and they telling me they will only pay R30000 from daily illness cover and they will only pay R37500 for stage 1 cancer AFTER the procedure is done.

Which still does not help me settle R149000 for hospital fees excluding doctors fees

I honestly feel there has been empty promises and breach in this contract.

It’s easy to debit my account to take your money

But it’s very difficult for them to assist us in our matter of emergency

I have contacted my lawyer and I will not let this rest

I will advice you stay far away from affinity health as this to me is a money making scheme

Mr Jugroop