HOW TO CLAIM ?

 

You will need to take the following steps when submitting a claim : 

Step 1 : 

Please submit the following documents in order for Easy Gap to process your claim 

• Complete your claim form (You can download HERE)
• Medical Aid statement for the Medical Service Provider you are claiming for 
• Medical Service Providers Invoices
• Hospital account

Step 2 :

• Claims can be submitted via email to info@easygap.co.za 

Step 3 : 

• Claims will be assessed in terms of the benefits provided by the selected policy

Step 4:

• Should we require any further documentation , an email will be sent to you and your broker advising you of the outstanding requirements

Step 5 :

• Once a claim has been assessed, valid claims will be paid directly to the Policyholder
• Valid claims are settled within 10 working days provided that all requirements are received.

Claims should be submitted in writing (i.e. complete the claim form as soon as possible) by no later than six months from the admission date into hospital. All documents are to be submitted within 365 days from the date of the procedure being carried out by a hospital/medical practitioner.  

Claim forms are obtainable from Easy Gap. Kindly contact us via telephone or email and we will assist you in facilitating the claim.

All claim assessments will be performed by the Underwriter.

Email: info@easygap.co.za

Tel: +27 87 550 8636

We will provide you with the claim form, this will be completed by you and submitted with the relevant supporting documentation. 

Please note, all these documents are required with every claim as each document contains relevant information required to process the claim .

Frequently Asked Questions About Claims:

Can my Gap Cover claim be processed and paid prior to the procedure ?

• No, a claim may only be submitted after the procedure has been performed.

How long do I have to submit a Gap Cover claim to Easy Gap?

• You have 6 months to provide written notice from the date of treatment of a pending claim. All documentation must me provided within 12 months to avoid your claim prescribing.

Once my Gap Cover claim has been assessed and a payment is made, how long will it take for the amount to reflect in my account? 

• When the payment will reflect in your account generally depends on with whom you bank. The time varies from 1 to 3 working days. In addition, Turnberry will send you a claim statement, which will provide details of your claim and the amount that will be paid into your account.

How long will it take to settle my Gap Cover claim?  

• Upon receipt of all the required documentation it will take, 5 to 9 working days for the claim to be finalised.

What documentation do I need to submit when I have a Easy Gap Cover claim ?

You will be required to submit the following documents :

• Turnberry’s claim form.
• Medical Aid statement reflecting the transactions processed by the Medical Service Provider for which you are claiming, as well as the transactions your Medical Aid has processed from your hospital account.
• Invoices from the Medical Service Providers for whom you are claiming.
• Hospital account for the period you were hospitalised.