Medihelp doesn't view heart failure as a medical emergency?

My elderly dad was hospitalized for over a week with heart failure and Medihelp says heart failure is not a emergency so they won't pay the ER doctor. They paid the ER facility fee (???) but are declining to pay the poor doctor because their day to day benefits are depleted.

Unfortunately I know what the law says :

All medical emergencies are prescribed minimum benefits (PMBs) which require full payment from a medical scheme.

The following factors must be present before an emergency can be concluded: 1. There must be an onset of a health condition. 2. This onset must be sudden and unexpected. 3. The health condition must require immediate treatment (medical or surgical).

My daddy has heart failure (ICD code i50.0), had fluid on his lungs again and was hypoxic. He received treatment in the ER (triaged orange) and was admitted to the hospital for further treatment. Medihelp has all the information, including his entire hospital admission records, pathology results etc that I furnished them with but they just ignore, deflect and decline to pay.

Each time I want to give Medihelp the benefit of doubt but they disappoint. It is shocking that they do not know what a medical emergency and PMB's are and that their paying clients must do the work for them. It is basics 101 guys. It seems like Medihelp has a very specific modus operandi which is to do everything in a manner that will delay. Their answers are robotic, stoic and they have no shame in giving you answers that are factually wrong and contradicting. Zero effort is made to provide quality feedback and responses. I sometimes wonder if this is all a sick joke to them.

Medihelp's days are numbered with us. My medical aid is with a big competitor who has never given me any issues with emergency rooms and PMB's, including covering all my ER costs with no issues despite me having a hospital plan. That is service. That is looking out for your customers by seeing they were in hospital for a emergency and taking the initiative to pay the costs, no work expected from their clients.

Medihelp your time will come, it might not be today or tomorrow but if you knew what your reputation was among medical providers, doctors and hospitals, you'd know it is time to do better. I was even cautioned by a hospital to move my parents to another medical aid sooner rather than later.

Medihelp once was good but those days are long gone it seems.