Medical aids acting inapropriating.

I got a porcelain crown on a tooth 3 years ago, but due to fierce biting at night, I bit it to pieces. I app**** for a metal replacement and was told it can only be done after a year. I waited a year and then app**** again. I was told to wait another 6 months, which I did. When I app**** then, I was told that Medihelp are not going to pay for a crown because there is too little bone left, and I have a choice to go for an implant and pay for it myself, and then they will pay for a crown on the implant, or I can have all my teeth taken out and get false teeth which they will pay in full. After several emails I asked to see the dental/medical qualifications of the people in their call centre, cause when I threatened to go to the ombud, I all of a sudden got answered by a senior employee. With every letter I wrote, the answer was that I must go to my dentist so he can explain to me what is the best to do. Then the dentist app**** for the umpteenth time for a crown replacement because that is the solution. Then they refuse and tell me to go back to my dentist. And today, after another motivational application by my dentist, ms Marie Weideman sent us an email with the answer in capitals, that MEDIHELP IS NOT GOING TO PAY FOR THE REPLACING OF THE CROWN! We have assured them that we understand a crown can be done only every fifth year. We have assured them that if the metal crown needs to be replaced before five years time, I will replace it on my own account. The dentist has send in another motivation to assure them there is enough bone for the metal replacement, the porcelain one only broke because I have quite a fierce bite while I'm sleeping, as do lots of people. What I want to know is, why did they keep telling me, it will be done as soon as the period of waiting is over, and now, after postponing it for almost 3 years, all of a sudden it cannot be done. Why didn't they tell me in the first place that they are not going to do it. And just for the record, I got my first metal crown, which was a replacement for a porcelain one that I also bit to pieces during the night, more then ten years ago and there is still nothing wrong with it.

I would really appreciate it if you could help me to blame and shame them for this ridiculous way in which they are operating! My dentist have sent almost ten motivations in a period of 3 years. Now they tell me, they don't look at the xrays or motivations they only look if the period of time has run out and then postpone it. But now they could not postpone it anymore, so then they looked at the xrays and applications and motivations for the first time, and now they decline it.

I really do smell a rat here! To me it seems they ran out of excuses.

I can send you all the emails, names of people, take note people cause it was another call centre person every time, then the senior mrs and at last a dental advicee which said they will look into it again, the dentist must just sent in another motivation, and now mrs senior answer rudely. I would like to see her medical qualifications as well.

Thank you. Looking forward for your reply.

Mrs j. L. Bothma