People say things to sell and cannot deliver on the expectations

I have been a talk sure client for a while now and have obtained both a medical aid shortfall cover and a help me SA membership. When I was approached by the company the thing that attracted me to the product was when I was told about the schemed rates Doctors charge and that this would cover the cost my medical aid did not cover. I submitted a claim 3 weeks ago 19-04-2018 to Ambledown as per my policy document. First off I was to receive feedback from them in two weeks as per the automated response. I received an email this morning with a letter attachment advising that my claim would not be paid to me as my son had been seen as an outpatient for a surgery.So basically the reason I took interest in s cover like this and pay my monthly premium is for incidents such as these. To avoid out of pocket payments. It is not okay to sell something to someone and give them and expectation but cannot hold up to the deal . If this matter cannot be resolved efficiently I will cancel my membership to both products and rather save that money for an emergency like this or pay elsewhere for a service I am comfortable with.