Claims

Gap Cover

Claim for shortfalls between what your medical aid pays and your actual medical expenses.

Follow these steps to submit a complete claim and help speed up the review and payment process.

We'll assess your claim, request any additional information if required, and let you know of the outcome within 7 - 14 working days.

Claim

Complete this form to get a response between 08:00 and 17:00 on weekdays.
For claim enquiries please call:0861 111 167

First names

Surname

ID number

Optional

Policy number

Optional

Cellphone Number

Upload your claim form and supporting documents

Upload your documentsAccepts .pdf, .jpg, and .png .doc .docx

Maximum combined file size: 10 MB.

faqs

What is the claims process?
Claims are processed by the Sanlam Gap Cover team:
After submitting the required documents, you’ll receive a claim acknowledgement email with a ticket number
Our team will assess your claim and keep you updated on its progress
Your claim is submitted for final verification
The outcome of the claim is sent via email.
How long will my claim take to be assessed?
Once all documents are received the claim will take 7-14 working days to assess your claim.

All documentation will be assessed before processing a claim. If there are documents outstanding, a request for these documents will be sent via email.
When will my claim be paid?
Once your claim has been assessed, any payment due will be made within 5 to 7 working days. Payments are made directly into the principal member’s bank account.
What happens if my claim is delayed?
A delay may happen if we still need certain information or need to verify the details provided. You can request feedback on a delayed claim by sending an email to gapclaims@centriq.co.za.
What if I’m not satisfied with my claim outcome?
You can request a reconsideration or submit a complaint for further review. If you’re still not satisfied with the outcome, you may refer your complaint to the Sanlam Arbitrator.

Claim types