Any excuse not to cover Patients

I had contacted Optivest health services for a Specific Medical aid that is, the Ingwe Any Plan from Momentum Health. The Consultant, Mr S Parbhoo assisted me with completing the application telephonically to which I answered to the best of my ability. The Broker advised me with regard to Pre-Existing Conditions (PEC), and requested that I declare all know PEC's for underwriting purposes. I had declared my Asthma as well as my SLE conditions and declared that, apart from odd doctor visit the my two kids were healthy and well. This was done in September. For whatever reason, Optivest health did not submit my application on time and my insurance was not activated for the month of October.

During the month of October i was contacted again by Optivest and confirmed that my cover will not be delayed for another month. I was told that ,should an emergency happen within the first 3 months of the cover, that i could go to the nearest hospital for treatment.

At the end of October I received confirmation from Momentum Health that i was a member and that I had two conditions on a 12 month waiting period, Lupus and Asthma. This was confirmed when we were call once more by Optivest in the first week on November.

My yougest daughter, who is 4 years of age, and is the 02 dependant fell ill in the last week January with OTC meds not working we decided to take her, in the first week Feb to the pediatrician, who wanted to admit her into hospital after consulting and hearing the sequence of events that led us to come to him.

We had then been told that Momentum required a clinical history form for which baby had seen him last year for a the flu.

We were admitted into hospital and scans were done with a drip inserted for antibiotic treatment.

Our GP completed the history form which showed a few visits to him but they were all treated within a short space of time with no real reemergence of symptoms. Momentum had then placed a 12 month waiting period on Liyana for Bronchitis and UTi for an entire year. My Argument is this how can a healthy child who has not shown any symptoms of a UTI for over 6 months be carrying around Pre Existing Condition - as stipulated by momentum. I have second, third and forth opinions by doctors and specialists that this could not be the case. If this is a precedent, shouldn't all women and babies in diapers get 1 year waiting periods on their medical aid applications as UTI's are common in married women and Now they have removed my youngest daughter from the scheme why is this????