Refuse to pay part of Emergency claim - Why have medical Aid

I visited the GCC as I had pains under my breast. The doctor ordered bloods and also did an ECG. Now I get a claims notification that some of the items for the emergency unit as not covered by the Day to Day benefits as out savings is exhausted. As far as I am aware I can even still get my treatment from the day to day. Now I get a booklet stating certain things are not covered. It does not state what are these certain things though. And neither do I know what ICD codes was used by the Emergency Department. Only to be called by the doctor the following day to inform me the ECG was abnormal. Thus ended up at my physician again with TIA & Bronchitis. Why would this not be paid whilst there are day to day benefits ? It is not like a podiatry claim …….