Fedhealth - where family cares about family -NOT

My dad was told by a cardio surgeon he has a hole in his heart which needs to be closed, he needs to for an op. The surgeon wrote a motivational letter like he does with all other medical aids. Fedhealth medical aid declines it. The surgeon phones them and explains, thinking it will be approved, my dad was getting ready for his op, stopped eating from early in the morning, only to be told, declined. Even the surgeon was shocked and couldn't understand it. I then contacted them myself, they tell me "it did not meet the criteria" I asked what criteria and was told it was their processes and has a lot of medical terms. I vented my frustration and got told by the team leader in authorizations that she will discuss it with the medical advisor/doctor this morning and they also waiting for the techs report, she advised me that on his plan he is covered for prothesis. I get told only at 12pm, after my dad hasn't eating anything again from the previous evening 10pm, it is declined as they feel it is not needed and that the chances of something happening is not high, it can be handled by medication. They not just declining the device but the whole procedure. This is unacceptable as he is covered for prothesis and the surgeon says he needs this op. Who is Fedhealth to refuse treatment that is recommended by a trained professional? I have told them over the phone and again I am now stipulating it in writing, if anything happens to my Dad, I will hold Fedhealth medical aid responsible.