Gross Negligence and ******* declination of PMB related medication

To whom it may concern:

Our familily has recently joined Gems 1 April in which a general waiting period is app****.

My wife has a condition that is multiple sclerosis (which is a PMB). Her associated medication that has helped her has been copaxone.

Despite following due procedure to register the pmb and chronic medication, the medication was declined. The treating neurologist has since submitted the required motivation for approval of the chronic medication and it appears the medication will be approved but when the general waiting period is over.

She has been had uninterrupted cover for many years at medshield and they were covering the condition. We now joined Gems and they are imposing a general waiting period on the medication in question.

In terms of the medical schemes act this is a negligent and ******* declination that the Gems underwriting team has initiated. PMBs and associated medication may not be subjected to waiting periods as she has not had interrupted cover in many years.

Kindly resolve this issue immediately or we will be taking legal action against Gems