Looking for loopholes to not pay legitimate claims

Medshield are the biggest bunch of *******. This medical aid was fair a few years back, but it's gone completely ridiculous. They want to pay NOTHING. Our plan gives us a budget for optometry for each of us. My son has virtually the full amount available to him as he has was on specsavers kids plan, where they receive free eyes tests and spectacles. So up until now this has not been something we needed to put through our medical aid. In the beginning of this year, the free frame that he received got damaged whilst he was playing, so spec savers gave him a replacement, they did not charge him the full value for the replacement frame, they only charged R200, which we put through the medical aid. My son NEEDS contact lenses, as he is an avid sportsman, and cannot play sport without it. We went to pick up his contact lenses this evening, and the claim was denied (he has nearly a full budget for eyewear available). The reason they gave for not paying is that suddenly he is allowed EITHER a frame or contact lenses in a year, which was never the case previously! That frame was paid for by spec savers - NOT the thieving medical scheme. The R200 for the replacement frame after it broke is not even a fraction of the value of his frame!! So they want to get away from paying R1050 of contact lenses in October, because we put through a R200 in Feb, leaving his entire optometry budget available and virtually untouched, ready to expire in a month or two whilst my son desperately needs contacts. How nicely that would work out for Medshield! We were forced to pay cash as my son has a cricket match tomorrow, and cannot play if he cannot see. I am so sick of this scheme. We are paying R4000 every month and almost never use this medical aid, but when we do, there is always a reason why they can't pay. If this amount is not refunded to us, rest assured I am going to try every means possible, whether I lay a complaint at CMS, or publish their thieving ways on every social media platform available. Trust me, I am not taking this laying down and allowing Medshield to bully me out my hard earned funds, whilst they cheat. You CANNOT get away with *****ing from people. Those contact lenses are covered, by law they must be paid.