GAP cover is a ***

<div>I took out gap cover a few years ago with Old Mutual Insuremed which stated they would pay short falls in hospital cover. I took this out as my medical aid pays 110% of scheme rates.

For the first time i have come to claim as i was in hospital for a procedure and I received a bill which the medical aid did not cover as the doctor charged 217% of scheme rates so there was a shortfall.

First of all the process to claim is ridiculous as you need a stupid amount of documents that state the same thing from the hospital, medical, doctor. Then i get feedback and my claim is declined because of PMB.

I do not understand the reason this is declined as the medical aids pay-out all things under PMB's at 110% for me and the in hospital procedure was no exception. So what can you actually claim for when you are in hospital?

I was sold on the fact that if there was a shortfall in hospital i would be covered and now when i need to be covered they declined for a reason that makes me question if they actually pay-out any claims. My money has been ****** for the last 3 years from Insuremed and i would warn anyone that is considering joining them to be very careful as they will tell you on the phone you are covered but when you claim they will find any excuse not to pay. </div>