PPS refused a pregnancy-related claim despite my gynaecologist declaring an urgent c-section due to fetal distress. They argued it wasn’t an emergency, yet their own policy states all c-sections and pregnancy complications are covered. This is a direct co

I am extremely disappointed with PPS. My spouse’s family responsibility leave claim related to my pregnancy-related sickness benefit were rejected, despite clear medical evidence and my gynaecologist’s declaration.

At 39 weeks and 2 days, my gynaecologist advised that we urgently book a caesarean due to failure of fetal descent. During the procedure it was confirmed that my baby’s umbilical cord was wrapped around her neck and my amniotic fluid was discoloured, indicating fetal distress. My doctor explained that delaying would have caused life-threatening complications for my baby.

Despite this, PPS declined my claim, stating the c-section was “not an emergency.” This is in direct contradiction to PPS’s own published policy, which clearly states: • All c-sections are covered, whether elective or medically indicated. • The pregnancy-related sickness benefit is not limited to emergencies and applies if a doctor books you off. • The SPPI benefit includes all pregnancy and childbirth complications, including c-sections.

References: PPS: Insurance and pregnancy complications https://www.pps.co.za/insurance-and-pregnancy-complications-what-you-need-know-0 PPS Pregnancy Benefit PDF https://www.pps.co.za/themes/custom/refresh/assets/pdf/Pregnancy.pdf

PPS’s rejection contradicts their own documents and disregards medical evidence. This experience has left me with no trust in their willingness to support members during critical and vulnerable times.