Gap Cover - Thank you!

I had to go for surgery in January 2019 and spent a night in hospital. My medical aid did not pay the entire amount of the surgeons cost due to their scheme rate (even though I was on a plan that costs more than R3,000 per month and covers up to 200% of the scheme rate). This left me with an out of pocket expense of R13,100 together with a huge amount of stress after surgery.

With the knowledge that I had Medical Gap Cover with Old Mutual, I submitted a claim form together with supporting documents to the administrator Insuremed on Friday, 25 January 2019. The claim form mentioned that the processing and finalisation of the claim could take up to 10 business days.

I received a response from the claims administrator that my claim was submitted for assessment within two business days. My claim was assessed within two business days and thereafter submitted for final approval which was completed 3 business days later. The payment was processed on 08 February 2019 and a proof of payment together with the tracing reference number was emailed to me of which I was able to verify with the bank. As I bank with a different the funds reflected in my bank account this morning and lifted me from the financial burden experienced during the past month. This entire process was seamless and resolved within the promised timeframe.

Thank you to Old Mutual for a great product and Marelize from Insuremed for her efficiency and for keeping me informed of my claim throughout the process. It is a relief to know that I have this policy with you especially when medical aids do not pay in your time of need.