Concern Regarding Gap Cover Advice and Policy Limits

Approximately a year ago, I completed a phone discovery call for Gap Cover to add to my existing medical aid after receiving high out-of-pocket bills from doctors.

During the call, I repeatedly asked the call center agent about the waiting periods and benefit limits before the cover would be fully active. A day or two later, the agent phoned me back and advised that there would only be a 12-month waiting period applicable to my daughter’s operation, which took place in January.

I again specifically asked whether the policy would cover additional doctors’ costs, and I was assured that it would, subject only to the limits applicable during the 12-month waiting period.

However, after submitting a claim this month, we discovered that there are additional limitations on the policy that were never disclosed to us during the discovery process.

Based on this experience, my advice is not to rely on information provided by the call center agent, as the information given to us was misleading and incomplete.

Kind regards, William Krugel