Pathetic service from the call center and refusal to pay service providers

I have a daughter who has downs and had a whole in her heart - my medical aid scheme refuses to pay the heart surgeon on the bases that it was a planned procedure. This then means to me that my daughter should have first had heart complications exposed to death before corrective measures can be done which would prevent such. In addition one of the consultants I had spoken to (this can be proved when they retrieve the calls) said this was approved for payment by their doctors and they will be processing payment. Their agents when speaking with them especially Bongi the one I spoke to yesterday has no empathy and speaks to me as though they are doing me a favor. I have some references that I took down for the calls I made and am disappointed that the scheme refuses to by the heart surgeon who has contributed in bringing longevity to my daughters life.