REFUSING TO PAY BILLS ON A PMB CLAIM

I Have been a member of this medical aid for many years with no major claims. My son was injured in a rugby accident in Durban in July, which was/is a confirmed PMB case , even with a motivational letter from his surgeon stating this and yet this medical aid is refusing to foot some of the bills. You try and explain to the case workers that it is a PMB and they shift the blame to the providers, now the latest is the claim is stale so it is the members responsibility. I will definitely be looking at a new medical aid for the new year .