Elixi - Gap Cover Claims

GAP COVER CLAIMS PROCESS

How to submit a Gap cover claim?

Submitting a claim for Gap Cover is a simple process. If you need to make a claim, your completed documents should be submitted in writing by no later than one hundred and eighty (180) days / six (6) months from the date of the incident and returned by email to claims@ambledown.co.za. In any claims case, it is wise to complete the claim form and submit as soon as possible.

The Step-by-Step Process:

Step 1: Request a health claim form from claims@ambledown.co.za.

Step 2: Gather the supporting documentation that is required to accompany your claim.

Detailed Hospital Accounts
Detailed Doctor(s) Accounts
Detailed Medical Aid Statement (line by line assessment of all transactions that relate to the hospitalisation)
Fully Completed Claim Form

No claims can be settled without copies of these documents present.

Step 3: Email your claim form and accompanying documents to claims@ambledown.co.za or fax on 011 463 1665.

The claims assessment period is a maximum of fourteen days from receipt of all the required documents. Failure to provide all applicable documentation to this claim form will cause undue delay in the processing thereof.

OUR PARTNERS

In order to deliver on our promise to you, we have partnered with Guardrisk and Ambledown who not only share our values and vision, but also our passion for ensuring that every South African is given the opportunity to access quality, private healthcare.

This is NOT a medical scheme and will not be a substitute for medical scheme membership. It fills the GAP between what is covered by your medical aid, and the actual amount charged by your medical practitioner for in-hospital procedures.

For more info click on the below logos.

For COVID-19 updates, visit the official website sacoronavirus.co.za |

We work with you to give you options that will suit you – your pocket, your family and your medical challenge.

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MEDICAL INSURANCE DISCLAIMER:

This is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership. The benefits are subject to waiting periods and applicable limits. These are outlined in the policy wording which you are required to read and understand. T&Cs apply. The increase would be based on risk and inflation rates. This is not your policy wording and for the full disclaimer please go to www.elixi.co.za/disclaimer-notice

Cubix Solutions (Pty) Ltd t/a Cubix is an authorised FSP 42788. Insurer – Bryte is a licensed insurer and an authorised FSP (17703). Unity Health: A division of Ambledown Financial Services (Pty) Ltd is an authorised FSP 10287.

GAP COVER DISCLAIMER:

This is not a medical scheme and will not be a substitute for medical scheme membership. It fills the GAP between what is covered by your Medical Aid, and the actual amount charged by your medical practitioner for in-hospital procedures. This is not your policy wording and for the full disclaimer please go to www.elixi.co.za/disclaimer-notice

Guardrisk Insurance Company Limited is a licenced non-life insurer and an authorised Financial Services Provider (FSP 75). Intermediary – Cubix Solutions (Pty) Ltd t/a Cubix, Authorised FSP licence 42788 Ambledown Financial Services (Pty) Ltd is an authorised FSP 10287

Please note that the premiums presented on this website are based on the current rates and is subject to an increase which takes place in December every year. The increase would be based on risk and inflation rates.