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TOTAL CARE GAP COVER APPLICATION FORM - 2012 An authorised financial services provider FSP No 40815 IMPORTANT INFORMATION Please complete this form and send it to your broker Alternatively you can send it to Sanlam Healthcare Management as follows By post to P. I hereby authorise Total Risk Administrators to deduct an amount of R. from my bank account monthly in advance for my premiums to the Total Care Gap Cover Insurance product.

How to fill out complimed application form

How to fill out Sanlam gap cover:

1. Visit the Sanlam website or contact their customer service to obtain the necessary application forms.
2. Carefully read through the application forms and instructions provided to understand the requirements and documentation needed.
3. Fill out all the required personal information, including your full name, contact details, and identification details.
4. Provide information about your current medical aid or health insurance plan, including the name of the scheme, the type of plan, and the plan's principal member details.
5. Specify the effective date you wish for the Sanlam gap cover to start.
6. Indicate your choice of gap cover plan and select any additional benefits or options you may require.
7. Review the completed application form to ensure accuracy and completeness.
8. Gather any supporting documents required, such as proof of identity, proof of membership with your current medical aid, or any medical condition statements if applicable.
9. Submit the completed application form and supporting documents to Sanlam as instructed, either through online submission, email, or by post.
10. Await confirmation of your application and any further communication from Sanlam regarding the approval of your gap cover.

Who needs Sanlam gap cover:

1. Individuals who have an existing medical aid or health insurance plan but want additional financial protection for potential medical expenses not covered by their primary insurance.
2. Those who frequently visit specialists or require hospitalization and anticipate high medical costs.
3. People who have dependents that are also covered under their medical aid and want to ensure their families' health expenses are adequately covered.
4. Individuals who are financially responsible for part or all of their medical expenses and want to minimize out-of-pocket costs.
5. Those who want the peace of mind knowing that they have extra financial protection to cover any unexpected medical bills not fully paid by their medical aid.
6. People who value having choices in their healthcare providers and treatment options, as the Sanlam gap cover allows for flexibility in accessing medical services outside of their primary insurance network.
7. Individuals who wish to have additional benefits and options that may not be included in their primary medical aid plan, such as dental, optical or wellness benefits.

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What is complimed gap cover?

Complimed gap cover is a supplementary insurance policy that covers the additional medical expenses not covered by a primary health insurance plan.

Who is required to file complimed gap cover?

Typically, individuals with a primary health insurance policy that has certain coverage gaps are required to file for complimed gap cover to help manage their out-of-pocket medical expenses.

How to fill out complimed gap cover?

To fill out complimed gap cover, you must complete the designated application form with accurate personal information, insurance details, and any relevant medical documentation.

What is the purpose of complimed gap cover?

The purpose of complimed gap cover is to provide additional financial protection against unexpected medical costs that are not fully reimbursed by a primary health insurance policy.

What information must be reported on complimed gap cover?

On the complimed gap cover, you must report personal identification information, details of your primary health insurance coverage, claims history, and specific medical expenses incurred.