GEMS WILL NOT PAY OUT FOR EMERGENCY C-SECT DESPITE DRs EVIDENCE!

I had 2 Csects (Oct 2014, Sept 2016) with the same Dr & same hospital. However, with the latter GEMS refused to reimburse me for an emergency procedure claiming the ICD10 code from the gynae was not sufficient evidence so they will just consider it as an elective!! The plan was of course to go natural (both times). I went into labor with the 2nd but unfortunately it ended with a C-Sect again. With the previous C-sect the same documentation had been submitted & accepted. Its been years of back & forth between hospital, doctor & Gems. The case worker at the hospital from the offset said to me straight out, GEMS IS LIEING, she sent me screen shots of their system that clearly shows EMERGENCY PROCEDURE. Having to cough up R18500 for a gynae alone & having to fight with them after being in a seriously vulnerable state after surgery has been a truly unpleasant experience. Furthermore, after requesting me to co-pay R10K hospital fee, I refused & they eventually settled this in Oct 2017! Of course, Doctors refuse to deal directly with GEMS (for this reason) so I had been forced to pay the gynae R18500 upon delivery not expecting even half the hassles from Gems with refusing to pay back. I also logged this CMS & GEMS requested partogram evidence. Had anyone known this was a requirement from the offset, it could have been saved then! BUT I did not even know what a partogram was at my 1st operation because it was never requested then. GEMS clearly doesn't want to pay out where due! I did not want a Csect! It was an emergency! I feel CHEATED & HELPLESS!