UNFAIR PROCESS - claim rejected

I am on the gold gap cover member. I submitted a claim for a procedure that my daughter underwent recently. The medical aid approved the procdure but rejected the surgeons bill as I am in my self payment gap. Ambledown rejected my claim for the following reason:<br> . Any procedure not covered or declined by the medical aid scheme. What nonsense. Absolutely ridiculous! The claims agent that took my call Mzo,further explained that had the medical aid paid towards the doctors bill, then only would Ambledown pay the claim??? how is this a logical explanation!!!!