Claims

Only Protect Plan and Legacy Series policyholders may submit their claims using the online submission form below. For holders of any other policy kindly contact CompliMed at admin@complimed.co.za .

Please take note:

Turnberry the Administrator must be notified of any claim within five (5) months calculated from the date of treatment and all documentation must be received within twelve (12) months. Please ensure that all documents requested below are uploaded with your completed claim form to avoid unnecessary delays.

Copy of your service provider’s/doctor’s account reflecting all transactions relating to the claim
Copy of the hospital account
Copy of your medical aid’s statement reflecting all transactions relating to the claim/treatment. Unfortunately an "acknowledge of payment" issued by your medical aid does not provide the necessary information.

Please note, based on the information provided the Administrator may need to request additional information and all outstanding documentation must be submitted within 90 days from the date the documentation is requested by Turnberry.

You may choose to submit your claim online or download the claim form, complete, sign and return the same together with all your supporting documentation to admin@complimed.co.za

Online Submission

Step 1 of 5

20%

Details of Policyholder
Policy Number*
Title*
Gender*
ID Number*
Date of Birth*

DD
MM
YYYY
Initials*
Name*
First Last
Postal Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Work Phone*
Mobile Phone*
Home Phone
Email*
Medical Aid Details
Company*
Option*
Medical Aid Number*

Details of Patient
Title
Name*
First Last
ID Number (If not available Date of Birth)*
Referring Doctor Name*
Referring Doctor Phone*
Claims for Cancer Only
Is this claim related to cancer?*
- Yes
- No
If so, please provide the date(s) of the consultation(s).*

Document Uploads
Copy of Hospital Account
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Copy of Medical Aid Claim Statement
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Copies of Doctor/Specialist Accounts
Drop files here or

Accepted file types: jpg, gif, png, pdf.
Other Additional Documents
Drop files here or

Accepted file types: jpg, gif, png, pdf.

Payment of Claims
Turnberry the Administrator reserves the right to negotiate a discounted rate with your relevant medical service provider(s) in exchange for direct payment to them. Please advise if you have paid your medical service provider(s)?
- Yes
- No
Bank Details
Account Holder's Name*
Name of Bank*
Branch Code*
Account Number*
Account Type*
- Cheque
- Savings
- Transmission
Banking Details Declaration*
- I declare that the banking details provided are correct, failing which, Turnberry the Administrator is not liable for any losses, charges and expenses. I accept that it is my responsibility to notify the Administrator timeously of any changes in my banking details. The indemnity payment may give rise to a potential Output Tax liability under section 7(1)(a) read with section 8(8) of the Value Added Tax Act.

Declaration by Principal Insured
Acceptance*
- I warrant that I am legally entitled to receive the benefits in terms of the said policy. Turnberry the Administrator shall not be liable for payment if the cause of accident/illness is related to an exception detailed in the policy document and any endorsements thereto. In support of a claim in terms of the said policy, I declare that all statements and answers which may now or at any time be given in connection with this claim, whether in my handwriting or not, are true and complete. I understand that any misstatement or non-disclosure, which materially affects the assessment of this claim, will entitle the Administrator to declare this claim null and void. I hereby authorise the patient’s Medical Scheme, any Hospital, medical service provider or any other person who has attended to or examined the patient, to furnish to the Administrator or the Administrator’s authorised representative any information with respect to any illness or injury, medical history, consultations, prescriptions or treatment and copies of all hospital or medical records. A copy of this authorisation shall be considered as effective and valid as the original. Should any benefit be paid by the Administrator and subsequently settled, in whole or part, by the patient’s Medical Scheme or the medical service provider/s reduced the amount they have charged, the amount of the overpayment will be refunded to the Administrator.

Treatment date of the claims is within:	Benefits for childbirth will be capped at:
First 12 months of the Policy	R8 000 per event
13-24 months of the Policy	R12 000 per event
25+ months of the Policy	Subject to the Overall Annual Limit of the Policy

Medical Service Provider	Amount Charged by Medical Service Provider	Amount Paid by Medical Scheme	Amount Paid by CompliMed®
Surgeon	R17,053	R6,021	R11,032
Anaesthetist	R8,256	R2,402	R5,854
		Total Paid by CompliMed®	R16,886

Claims

Only Protect Plan and Legacy Series policyholders may submit their claims using the online submission form below. For holders of any other policy kindly contact CompliMed at admin@complimed.co.za .

Please take note:

Step 1 of 5

Details of Policyholder

Medical Aid Details

Details of Patient

Claims for Cancer Only

Document Uploads

Payment of Claims

Bank Details

Declaration by Principal Insured