I submitted my claim online, received a response via email in which my claim was rejected and the statement did not even include all the claim items/invoices that i had submitted online

I submitted my claim online, received a response via email in which my claim was rejected and the statement did not even include all the claim items/invoices that i had submitted online. I escalated the claim and it was rejected again. I had to further escalate the matter again where it was referred to a specialist and then only approved. For context, it was in relation to a drowning incident for a 10month old baby where we had to take her to the ER on a sunday evening and she had to have chest Xrays to determine whether there was water on the lungs. I kept having to ask for the reason as to why my claim was being denied considering there is cover for children under 12 after hours emergencies as well as an accidental casualty/emergency benefit in general. Was trying to understand what would actually then constitute an emergency after all.