Claims

Gap Cover

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

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  • How to claim
  • Submit claim
  • FAQs

How to claim

Follow these steps to submit a complete claim and help speed up the review and payment process.
How to submit your claim
  • Download and complete the gap cover form

  • Prepare supporting documents, as listed in page 1 of the form

  • Email claim form and supporting documents to gapclaims@centriq.co.za.

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

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Claim

Submit a claim

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

0861 111 167

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Upload your claim form and supporting documents
Accepts .pdf, .jpg, and .png .doc .docx
Maximum combined file size: 10 MB.
faqs

Your questions answered

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

How can we support you

  • How can we support you
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Funeral and life claims

A loved one has passed away and you need to cover funeral costs.
  • Life cover on a savings policy

  • Funeral cover

  • Funeral benefit from life cover

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    Medical and disability claims

    Cover medical, illness, hospitalisation or disability expenses.
  • Sickness benefit

  • Hospital admission for One Medical Plan

  • Severe illness, dread disease, or child illness

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    Work and income-related claims

    An illness or injury has affected your ability to work or earn an income.
  • Illness or injury benefits

  • Disability or accident benefits