Claiming against your gap cover plan

Before we go over what you will need to make Gap cover claims, let’s have a look at what gap cover is.

Trips to the hospital are something that we’d all like to avoid. Realistically speaking, though, at one stage or another, you will need to go into hospital.

Now, whether that is as a result of an emergency or for the treatment of a disease, the cost can be scary.

We are talking of thousands of Rand for even a couple of days and the most routine treatments. And the costs for specialist procedures such as a heart bypass are enough to give you a heart attack.

Gap cover Claims are Easy to Process

Gap cover claimsYou would think that your medical aid would have you covered but you might be wrong on that score. Most medical aid plans do cover hospital visits but there is a limit to how much they will pay.

And that could leave you in the uncomfortable position of having to find a lot of money in a hurry. The shortfall, especially when it comes to private hospitals, can be astronomical.

A friend of mine found that out the hard way. She was involved in a car accident and taken to the nearest hospital. While she was recovering, she didn’t worry about how much things would cost because she has a premier plan. Her medical aid pays double the standard medical aid rates.

So, when she received a bill from the hospital, she ignored it. She thought that the medical aid had paid it. It was only when the hospital account’s department started to phone her that she learned the truth.

She tried to resolve the issue by contacting the medical aid and found out what “200% of medical aid rates” actually meant.

It was too late to do anything about it though, she had to pay a bill of R16  000. She eventually came to an agreement with the hospital to pay it off in monthly instalments but had to pay interest as well.

Gap Cover is Essential to Your financial Health

If my friend had taken out a gap cover policy before this incident, things would have worked out very differently for her.

Instead of her having to find the R16000 the medical aid didn’t pay, her gap cover plan would have paid out.

You can Buy Shortfall Insurance anywhere

The advantage of gap cover is that you don’t need to jump through hoops to qualify. You don’t even need to go for a medical.

Some companies place restrictions on entry in terms of age. Aside from that, though, the only restriction is that you must be a member of a registered medical aid in South Africa.

The cover is also pretty affordable.

Gap cover Claims require All the documents but are Simple 

To claim from most of the gap cover companies is easy. You will usually just need to complete a form and then submit documents to support the claim.

These documents will usually include:

  • The original bill
  • Proof of what your medical aid did pay
  • A certificate from the medical aid confirming that you are a member
  • Proof of your admission into hospital and the length of your stay
  • You might also need to submit a copy of your ID, proof of address and a bank statement

To get a FREE gap cover quote, fill in the form on this page and submit

All info was correct at time of publishing