Poor service from Guardrisk/Medgap/Admed. After four months still no refund for an internal prosthesis that was partially paid by Bonitas and the balance by myself.

My wife had an operation on 08/05/2023. On 08/05/2023 we had to pay R 30,000 towards the internal prosthesis shortfall. Then later we had to pay a further R 6,036.28 directly to Montana Hospital, for the balance of the shortfall, not covered by BONITAS MEDICAL AID. The Gap Cover product is called Medgap, and it is underwritten by Guardrisk. In between the different email addresses, I also got some emails from an "Admed" email address. I am not sure if Medgap has changed its name or not. Anyway, the email addresses on the manual claim form and the people that eventually respond to you, respond from many different email addresses. When I initially lodged my claim in May 2023, for the shortfall of the internal prosthesis, the claims assessor reminded me about a turnaround time of a few days, which is not stipulated in any of the brochures that I have received. Anyway, it is now a few days short on 4 months and I still have not received any payment towards the internal prosthesis, which is definitely covered according to the claim form. When the claim in question was acknowledged by Guardrisk beginning of August, the email stated that I would be kept informed about the progress of the claim, but nothing has happened since then - not status update as promised! My wife suffers from 2 autoimmune diseases, and she therefore cannot work. I got gap cover to help me afford medical procedures that Bonitas doesn’t cover, needless to say, that I had to get extra finance for the unforeseen medical shortfall, caused by Guardrisk.

I am sorry to say, that I can not recommend the Gap Cover product, underwritten by Guardrisk, to anyone else.