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SA's No 1 Insurance Blog

Today we’re asking two questions:

  1. Is gap cover a waste of money?
  2. Is Zestlife just out there to take your money?

Before we answer those questions, here are three things we hate about medical care in South Africa:

  • Spending thousands of Rands a year on medical aid when we seldom claim
  • The thought of having to pay a penalty if I’m a late joiner, but not getting a discount if I never claim, and
  • Having to pay a gap cover company to do what my medical aid is not doing.

So could the money you spend on gap cover be better spent elsewhere?

Well think about this for a moment:

Why would the biggest open medical scheme in South Africa launch their own gap cover product? For that matter, all the major medical schemes offer some form of gap cover product?

We’re about to share with you a behind the scenes look at what goes on at Zestlife. Hopefully, this will persuade you as to why you need gap cover. Now on to the second question:

Is Zestlife just there to take your money?

Look, I hate being ripped off as much as you do. There’s nothing worse than paying for something and then listening to “um’s and ah’s” when it comes to your claim. So if I’m going to recommend a company like Zestlife, then I’d like to know a little about their claims history. Only fair, right?

One thing we need to understand about gap cover is the fact that they can’t perform the function of a medical scheme. So if your medical aid doesn’t pay for a procedure in terms of their rules, then the gap cover company cannot pay for that procedure either.

Now on to Zestlife & their 2018 claims

What does this tell us?

So if we look at the statistics, it seems that most people should have gap cover.

It also tells us that Zestlife is in the business of paying valid claims, and personally, I’m thankful that there are companies willing to pay the shortfall. What would we do without them?

And here’s something else I thought about.

Take your car and home insurance company for instance.

Too many claims and they either increase your cost or they ask you to take your business elsewhere. A cellphone lost here and a small bumper bashing there – it all adds up.

But with gap cover it’s different.

Your doctor recommends a procedure. Your medical aid authorises the procedure, and your gap cover picks up the shortfall up to a limit. There’s absolutely no reason for them to decline your claim unless:

  • You failed to disclose all information at the application stage,
  • You’re still in a pre-existing condition waiting period, or
  • You claim for one of the policy exclusions, or
  • The procedure was not paid for in terms of your medical aid rules

So that said…

If you don’t have gap cover right now & you’re a member of a medical aid then you should seriously consider Zestlife Gap Cover. NB: You have to be a member of a medical aid in order to join Zestlife. Cover starts from only R247 per month.

Zestlife is an authorised financial service provider. FSP Number: 37485. Policies are underwritten by Guardrisk Insurance Company Ltd. (FSP number 75)

If you would like to receive a quote from Zestlife, simply leave your details below & they will get in contact.

Leave us your thoughts in the comments section below.

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