HH
Hugo H

1 reviews | Active since May 2015

11 May 2021, 08:44

Useless reason to have gap cover

I was in hospital recently for a hernia operation that unfortunally didnt take place because of a heart condition that happened in hospital while I was there. The hospital submitted a shortfall claim of R47 040.17 and now I get told the following:

Reason for non payment of claim Shortfall benefit exclusion: Hospital and day clinic fees, including theatre charges, ward charges or any other hospital or day clinic costs - In terms of the policy terms and conditions, hospital and day clinic charges are excluded from cover. As this claim is in respect of a shortfall on hospital or day clinic charges, no benefit is payable.

What is the reason then for having Gap Cover if they are not prepared to assist you with unforeseen matter like this!!!

If they are so unprofessional to inform you before hand about this and what they pay for and what not - what is the reason for having a cover like this!

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