Making a Gap Cover Claim from Sanlam

Going into a hospital is something that we are never really fully prepared for. Especially the costs. However, all you need to do is make a gap cover claim from Sanlam to meet the extra, unexpected bills.

Many people think that because they have a medical aid plan, there should be no extra costs, so why worry?

This sort of thinking gets a lot of people into trouble.

It’s all in the fine print when it comes to your medical aid and how much they will pay.

Make a gap Cover claim from Sanlam for Excessive costs 

Make a gap cover claim from SanlamYou probably know this – perhaps you’ve had to settle the excess on a few doctor’s bills when they were outside of medical aid rates.

What may come as a surprise to you, however, is that medical aid rates apply when it comes to hospital bills as well.

Which means that you may not have the full cover that you think you do. If your bill is higher than the standard tariffs, you have to pay in the excess.

The medical aid firms are quick to say that they pay 100% of these tariffs. They are also ready to enforce the rule. Those in the medical field will charge a lot more than these rates.

Gap cover with Sanlam

Luckily, gap cover can step in and take over for that portion not paid by your medical aid. With cover being less than a couple of hundred Rand a month, it will also not break the bank.

Who can Join up

That’s the good news – signing up is simple. There are no medical checks. As long as you are younger than sixty and a member of one of the country’s registered medical aid, you can apply. (Your medical aid membership must be current.)

Cover for Everyone in your Family

Listed dependents on your medical aid include your husband/wife/partner and children not older than 27.

All good Things come to Those who Wait

There is a three-month waiting period before cover takes effect. There is no cover in the first year for any expenses related to pregnancy or conditions diagnosed before taking the policy.

Make a Gap cover Claim from Sanlam 

The cover is pretty simple.

  • You cannot claim for cosmetic surgery unless you have been in an accident or have cancer.
  • The same applies when it comes to dentistry.
  • You will not be covered for any surgery meant to help you lose weight.
  • The cover only extends to treatment received in the hospital.

Claiming from Your Policy

You will need to submit the claim form, along with the supporting documents. These include copies of the bills; proof of what your medical aid paid, a certificate from your medical aid and proof of your admission to hospital.

You need the certificate from the medical aid to prove that your membership fees are up to date.

Claims are paid out relatively quickly as long as you provide all the required documentation. The money will be given to you and not to the suppliers. This is a legal requirement for these policies.

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

All info was correct at time of publishing