Refusal to make payment

On 21 August 2017, I had an accident with a knife and cut my thumb. I immediately went to the casualty ward at Blaauwberg Hospital and was assisted promptly. Two months later, I receive a bill from the hospital stating that I need to pay for the consultation on 21 August because the savings on my medical aid have been depleted. At this point, I'm quite confused because this consultation should have been paid by my medical aid (Fedhealth) out my risk option, and not savings.

I call the medical aid and they tell me that the payment was not made because I did not submit authorization within 48hrs. Furthermore, any late submissions would warrant a R1,000 penalty. This is news to me because it was not the first time that I was at the casualty ward and I did not require authorization in 48 hrs.

I'm extremely unhappy about this, I pay over R3,500 per month to this company so that I don't have to worry about medical expenses should I get sick, and the one time this whole year that I claim from the risk plan, they refuse to pay an R830 bill.

To use an administrative loop-hole to refuse settlement of claims is extremely *********. I'm so disappointed in this company.