No payment for approved procedures

I have been struggling since July last year to have a claim paid for a procedure that was approved by this fund. Now suddenly they reckon it is a repeat of a previous operation. Sitting in their air-conditioned offices they make decisions that impacts you but does not even find out the facts. The operation they refer to was done more than 15 years ago and the new operation was not on the same level of vertebrae. If they cared to speak to me, they would have known that it not a repeat on the same affected area and the previous operation was not kept a secret. they are not living up to their empty TV advert "The fund that always thinks about you". Rather it is the fund that always try to take your money and leave you hanging......