1 reviews | Active since Jun 2019
STAY AWAY FROM GapRisk!
Worst service ever. You cannot call the consultants that handle your case - you can only email them. When we finally got hold of someone at their national call centre, they could not even directly call the consultant or put us through to the person. They also had to send an email.
First the consultant wanted the hospital bill from a completely wrong hospital. Then he asked twice for documents that we already submitted. Then he asked for proof that the treatment was not for an existing illness, and less than 24 hours later, before we could even provide the proof, he wrote back to us and told us that the claim was not successful and that they will not pay for anything. Even though we had medical aid clearance etc.
I'm cancelling my membership TODAY. The payments for the last year could have covered at least R4000 of the outstanding bill. STAY AWAY FROM THEM
Thank you for your feedback. Any feedback, positive or negative helps us improve our service and product offering.
After investigating the reason for your unhappiness, we found that your submitted claims had not met the necessary requirements (stipulated in your policy wording) and was unfortunately repudiated. In your policy documents, we make clear mention of all instances where claims cannot be honored by us as we are not a medical scheme and do not provide the same benefits. Your claim was submitted within the first 12 months of coverage, therefor the request for a diagnosis report to ascertain whether this was not a pre-existing condition (which is excluded for 12 months). During the assessment process it was found that your claim was for a condition listed under PMB benefits (Prescribed Minimum Benefit) which is excluded on your GapCover option, but, normally covered by your medical scheme.
We beg that all policy documents be read, and also for your understanding.
Thank you for your feedback. Any feedback, positive or negative helps us improve our service and product offering.
After investigating the reason for your unhappiness, we found that your submitted claims had not met the necessary requirements (stipulated in your policy wording) and was unfortunately repudiated. In your policy documents, we make clear mention of all instances where claims cannot be honored by us as we are not a medical scheme and do not provide the same benefits. Your claim was submitted within the first 12 months of coverage, therefor the request for a diagnosis report to ascertain whether this was not a pre-existing condition (which is excluded for 12 months). During the assessment process it was found that your claim was for a condition listed under PMB benefits (Prescribed Minimum Benefit) which is excluded on your GapCover option, but, normally covered by your medical scheme.
We beg that all policy documents be read, and also for your understanding.