Gap Cover - Post Treatment or Procedure Claim

To claim against your Cinagi gap cover benefits you need to complete this form and attach all the relevant claim documents once prompted.

The supporting documentation that will required is as follows and can be uploaded online while completing this form:

• The relevant account from the doctor/provider
• The claims statement from the medical scheme showing how they have processed and paid the above account
• The first 2-3 pages of the hospital account showing the admission/discharge dates, ICD-10 codes, patient name, etc (if applicable)

Claims are processed continuously and are paid daily.

Once we have finalised your claim we will issue you with a claim remittance via e-mail.

Important : Cinagi can’t start with the assessment of your claim until we have received a fully completed claim form and all the relevant supporting documentation.

You can contact us if you need any assistance by clicking HERE .

Policy Holder Details

Patient Details

Details of Medical Service Providers

Shortfall Details

Document Upload

Please note that we cannot use the summarised statement that gets automatically e-mailed to you for processing gap cover claims. Please follow the following quick steps to download the correct document required for submitting your gap cover claim:

Step 1: Go to: https://www.discovery.co.za/portal/index.jsp and login using your username and password.

Step 2: On the top menu bar, select “MEDICAL AID”.

Step 3: At the bottom left in the drop down menu, click on “Medical Claims”.

Step 4: Click on the 3rd block that reads “Download a claims document”.

Step 5: Click on the 2nd option on the right that reads “Claims transaction history”.

Step 6: Once selected you can specify the date range in the “Transaction history criteria ” section. This range will need to include the date of when your procedure/treatment occurred.

Step 7: Once you have entered the correct dates, select “Show the results in a printable and downloadable PDF document” and then click Submit.

Your browser will then download a PDF document which you can upload to us in order to process your gap cover claim.

Additional Documentation