Gap Claim Form

Consolidated Gap Claim Form 2026
  • Instructions
  • Policyholder Details
  • Payment Instructions
  • Patient and Event Details
  • Declaration
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Broker Submission
Your Full Name (broker submitting on behalf of the policyholder)
Your Full Name (broker submitting on behalf of the policyholder)
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Please enter your ID, Passport No. or your Gap Policy No. in order for us to find your policy.

Please enter the Policyholders ID, passport No or Kaelo Gap Policy number in order for us to find the Policy
What would you like us to search with?
Please ensure you enter the cellphone number that is linked to your policy. You will receive a OTP to verify your policy and continue with the online submission for your claim.
Please enter the OTP that was SMS'd to the cellphone number provided on the previous screen.

Should you not receive the OTP within a few minutes, please click the Next button and a new OTP will be generated. 

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