Terrible product

I recently lodged a claim for my doctor's bill and was called last week and informed that the claim was declined. The consultant mentioned that the reason for declining in PMD. I asked to speak to a superior who eventually reviewed and re-opened the claim and then said that they will match the amount paid by medical aid for spine condition. I disputed this and she said she will get back to me. Nobody ever did, I don't even have a claim number as there was no communication. This morning I noticed a payment into my bank account. There is still a huge shortfall on the doctors bill. I've been paying this gap cover for years on the basis that this cover will bridge the gap between medical aid and gap cover charges. They have rejected a previous claim which is currently at the Ombudsman. This has to be the worst gap cover, I can't understand what the purpose of their product is and totally shocked that this is how old mutual conducts business. I cannot trust them.