Regretting using Sanlam for my Gap Cover

I recently submitted a claim for a co-payment of R 8 800 with regards to using an out of network hospital that is not part of my medical scheme plan. I partially paid for the co-payment & submitted proof. I receive an automated template email stating the following:

“Dear Valued Client,

Thank you for your email, your ticket number is wf_***

Kindly take note of the Sanlam Gap smart claims process below. In our experience clients who have not completed the attached claims form are more likely to experience delays in the processing of their claim. Please be aware that this process may result in a number of back and forth communication before we can successfully process your claim.

We hope our new smart claims form and process will assist in ensuring your claim is finalised as soon as possible. Please ensure that you complete the attached smart claims form in full and send us the required supporting documents as requested on the form including:

• The claim form • The relevant account from your doctor • The claims remittance from your medical aid • The hospital account

PLEASE NOTE: Without these documents, your claim cannot be submitted for processing and your ticket will be closed. The claim will only be processed once we have received all the documents required. “

I called Sanlam Gap Cover and they inform me that they were requesting medical aids invoice claims document to verify the R 8 800. I explicitly told them that the co-payment is a payment directly paid to the hospital therefore Discovery will not have a claim for that co-payment. Nonetheless, I submitted the claims documents. I then received another automated template stating the following: “Dear Valued Client,

Thank you for your email, your ticket number is wf_***

Kindly take note of the Sanlam Gap smart claims process below. In our experience clients who have not completed the attached claims form are more likely to experience delays in the processing of their claim. Please be aware that this process may result in a number of back and forth communication before we can successfully process your claim.

We hope our new smart claims form and process will assist in ensuring your claim is finalised as soon as possible. Please ensure that you complete the attached smart claims form in full and send us the required supporting documents as requested on the form including:

• The claim form • The relevant account from your doctor • The claims remittance from your medical aid • The hospital account

PLEASE NOTE: Without these documents, your claim cannot be submitted for processing and your ticket will be closed. The claim will only be processed once we have received all the documents required. “

I honestly cannot wait to end my relationship with Sanlam, you can’t event email the missing documents which relate to co-payment instead Sanlam copies and pastes an email template.

I am going to explain this one more time. THIS IS A CO-PAYMENT, THE PARTIAL AMOUNT I PAID IS SHOWN IN THE HOSPITAL ACCOUNT. MY MEDICAL AID PLAN REQUIRES A R 8 800 CO-PAYMENT TO BE DIRECTLY PAID TO THE HOSPITAL & I PAID R 4 400. The level of incompetence shown by Sanlam is staggering!