Claims submitted to GapX will require the below documents in order to process.
Gap Cover Claims:
- Medical Aid Statement
- Provider invoice for each provider
Co-Payment, Penalty Fee or Admission Fee Claims:
- Medical Aid Statement
- Proof of payment
- Hospital Account
Emergency Room Claims:
- Medical Aid Statement
- Hospital Account
Primary Care Claims: (Specialist, GP, Dental and other consultations)
- Medical Aid Statement
- Provider invoice
Cancer Diagnosis:
- Histology Report
Cancer Shortfall and Cancer Top-Up:
- Medical Aid Statement
- Provider invoice
Accidental Death Benefit:
- Death Certificate
Gap Premium Waiver and Medical Aid Contribution Cover:
- Death Certificate or Disability Report
- Certificate of membership for Medical Scheme. (This will need to be submitted monthly to confirm status of your Medical Aid cover.)
For all other benefits not mentioned above, please submit your Medical Aid Statement and the Provider Invoice.