Disappointing gap cover

So this is what TRA advertise on their website:

Reliable Gap Cover Four tailor-made products to cover your needs The gap is covered in instances where there is a shortfall between what service providers charge and what your medical aid scheme will cover for in-hospital expenses.

However this has never been the case with them since I have taken up gap cover with them. Every claim has been rejected due to them deciding what conditions according to their rules is PMB and when the medical aid needs to cover the account is full. When enquiring about it the member is being advised that its the members responsibility to make sure the medical aid covers the bills according and also to liaise to get all the relevant paperwork from the medical aid to them in order to reconsider the claim. When asked to assist in the matter you are told they can not act on your behalf however with a previous claim they liaised directly with the medical aid to get all the relevant documents and icd 10 codes to finalise the claim because we as the members have no clue as to what the medical boards scheme rules are.

Funny thing is they advertise with so much confidence and cheat one into believing you have peace of mind just to sit with this frustration every time. These gap covers and medical aids sure as hell knows how to make their money and leave the member with more stress than they already dealing with due to health issues.

Please change your marketing strategy because this is a blunt lie!!

I will not recommend them to anyone!!