Unjust Claim Rejection & Poor Service

I am writing to express my deep frustration and dissatisfaction with the handling of a recent emergency medical claim — an experience that has been riddled with poor communication, lack of urgency, and an overall failure of service on your part. On 2 March, my husband required urgent medical attention due to a serious issue with his eye. We booked an appointment with an optometrist on the Dis-Chem network, who referred us to a specialist as a matter of urgency. Despite multiple attempts, I was unable to reach your call centre for authorization just prior to the appointment — which took place 10 minutes later. Given the seriousness of the matter and the failure to respond, we had no choice but to proceed and pay R2000.00 in cash. The following week, I contacted your offices to confirm the process for claiming. I followed the instructions I was given, received authorization from a case manager, and submitted the claim immediately on 17 March. By 19 March, having heard nothing, I followed up via email. Within five minutes of that email, I received a rejection notice. I called to query the rejection — since I had an authorization number — and was told the case would be escalated. On 25 March, still with no resolution, I called again. I was told — once again — that the case would be escalated. Today, I followed up again, only to hear the exact same response. No feedback, no timelines, no progress — just another promise to escalate. Next week is a short week, which I have no doubt will cause further delays, and your agents are consistently unable or unwilling to provide turnaround times for these so-called escalations. This is unacceptable. This has now dragged on for nearly two months, despite the emergency nature of the situation and my consistent efforts to follow up, follow the correct process, and provide all required documentation. Your service is disorganized, frustrating, and entirely lacking in accountability. This ongoing delay is not only financially and emotionally taxing, but it is also a complete failure in delivering basic member support. I am requesting urgent resolution, confirmation of reimbur*****t, and a clear explanation for the repeated delays.