ATROCIOUS SERVICE FROM HEALTH SQUARED

So my mom (75) signed up with Health Squared Medical Scheme on a Hospital plan. She is a pensioner and the Hospital Plan takes up her full pension. About 2 weeks ago she got really sick with heavy abdominal pain and she saw the doctor who wanted to admit her and run couple tests as I understand it to confirm what exactly her problem is. This was 9 September 2019. Ever since we have been battling to get authorization from Health Squared. The one after the other report was apparently required from the doctor which was sent to them. Then the Scheme doctor and the scheme decided that her condition does not warrant admission. Because they decided on the code that was sent through that she can be treated outside hospital. When asked what the hospital plan was for then, I was told for sickness to be admitted to hospital. But her condition does not warrants admission. So they have decided. I asked the consultant who gave his name as Ntumelo (if it even is his name) that I would like all the reports emailed to me and even gave my email address after which he just dropped the phone on me. Now my question to Health Squared is, do you inform the public that you are covered but you are not allowed to be admitted. As the consultant told me she is not with the scheme for a full year. Now I battle to find the part in the documentation that says you are not allowed to get sick within the first 12 months. I also battle to find the part where it says that you can get sick but you may not be admitted. My next question is should anything go wrong with my mom, who is to blame? surely not the scheme. I am sure there will be a loophole for that as well. I am also sure I am not the first person to complain about the bad service from Health Squared.