Diagnosis given without proper evidence
My son was scheduled to go for a MRI two months back as he has recently been diagnosed with Juvenile Scoliosis (he is 7yrs old). As we have only been on our medical aid for 9mnths the medical aid requested further information from the Pedestrian to make sure it was not a pre-existing condition. The Paediatrician told the medical aid my son has Cruzons Syndrome which is what cause his scoliosis, A.) He does not have Cruzons and the Paediatrician has no medical evidence to back this claim. B.) Scoliosis is not caused or part of this syndrome family. Now medical aid refuses further treatment and it will affect us getting his back brace as well. Between the medical aid as well as the paediatrician there seems to be no haste in rectifying this mistake which is causing us a lot of emotional stress as financially we cannot incur the cost of the MRI and the brace.
I suggest you get a second opinion from another respected Pediatrician which supports your viewpoint. Then you should get a lawyer to write to the medical aid scheme a letter requesting them to fulfill their contractual obligations or face legal action.