Bad Bad Service

I submitted a claim on 20-Sep for a procedure that took place 2-Sep.

On 11-Oct I get this in an email: We have assessed your claim and have found that the shortfall should have been covered by the Medical Scheme. Your claim is now with a specialist who is liaising with the medical scheme administrator. What happens now? We will provide the medical scheme administrator the evidence they need to pay the correct amount. If the medical scheme provides additional information that we are not aware of, or if they refuse to adjust the benefit payable then we will keep to our policy commitments and pay the claim. Please note that these types of enquiries may take longer to finalise, but we assure you that we have it all under control. If you have any questions, we will gladly assist.

Follow up after follow up and till no response nor payment!