Sick and tired

I have been a member of their plus plan for a long time and paying for that. 6 weeks ago i went to Eugene Marais hosp with my daughter that broke her arm. It was on a Sunday and i had to pay R400 from my pocket and afterwards another R1399 for the hosp. They told me the fund was exhausted. It was the first serious injury for the year. My problem then came as i was trying to send the claim to my fund. I still did not get ANY response from them about why i had to pay that amount while i am on the highest plan. Even if someone can just answer me it would have been better. I realy am considering moving my family to another fund as it seems they do not care about us as members!