David & Goliath Struggle

Cape Town parents go head-to-head with giant medical aid scheme that refused to pay for their newborn’s care

- Lesego Mkhize

Becoming parents for the first time can be magical – but when something goes wrong and your baby ends up fighting for her life, it can be terrifying too.

Just ask Jens Herf and his partner, Aude, from Fresnaye in Cape Town (Jens asked YOU not to include Aude’s surname). They’d been together for almost three years when they heard they were going to have their first child last year and they were delighted. Yet their tiny daughter came way too early and needed urgent medical treatment.

As stressful as it was, Jens at least comforted himself with the fact he had medical aid. But, as he was about to find out, plenty of drama and heartache lay in store for the little family.

Aude developed complications in her pregnancy and doctors needed to medically induce labour at 27 weeks to save the baby. The couple were horrified when their medical aid scheme, Genesis, refused to pay for the procedure, putting their unborn child’s life at risk.

Jens (44) and Aude (35) laid a complaint of negligence against Genesis with the Council for Medical Schemes (CMS) last year, and the regulatory body ruled in the couple’s favour.

The medical aid scheme was ordered to honour its medical bills, which amounted to hundreds of thousands of rands.

Yet one year on, Genesis hasn’t coughed up a cent. It’s also refused to recognise the couple’s daughter as a member of the medical aid scheme and is questioning the little girl’s paternity.

Jens describes the doubts around his paternity as ludicrous. They’re outraged by the treatment they’ve received from Genesis, he tells YOU.