Submit GAP Cover Claim

We hope you’re feeling better and have fully recovered. We want to help you get your GAP claim paid as easily and quickly as possible.

Treatment for accidents and the 24-hour medical information helpline and trauma counselling are available after your first successful payment. All other procedures have a 3-month waiting period. Pre-existing conditions have a 12-month waiting period.

It's important to know that you have 180 days (6months) from the date of the first treatment to submit your claim.

Before any claim can be settled, copies of the following documentation relating to this particular claim/s are required:

• I have checked the waiting period for the procedure I am claiming for and I qualify.
• I have checked that my medical aid has covered me for this procedure and there is a shortfall to be paid.
• I have checked that my medical aid has not paid my procedure in full.
• I was admitted to hospital or I have checked if the out-patient treatment type that l am claiming for is covered.
• I have all my documents ready to submit my claim
• I have completed my claim form in full and signed it.
• I have my detailed doctor/specialist doctor accounts including the ICD-10 codes).
• I have my detailed hospital account (including the ICD-10 codes).

You can download the g-App on your mobile phone to submit and track your claim, quick and easy. (Failure to provide all applicable documentation to this claim form will cause undue delay in the processing thereof)

If you have any questions about this process, please contact us on 086 199 0000