Claim outcomes are determined solely by the insurer
in accordance with the policy terms.
What This Means
If a customer has questions or disputes a claim outcome, they must contact their insurer directly.
Your Role
If a policyholder has a question or disputes the outcome of their claim:
You must direct the policyholder to contact their insurer directly
You are not required, and must not engage, in discussions regarding:
Claim assessment decisions
Claim outcome determination
Dispute resolution
Important Notes
GapOnly facilitates the claim, but does not determine policy coverage
Insurers are responsible for final decisions
Your practice remains solely responsible for all clinical decisions, treatment recommendations, and medical advice provided to policyholders
Need Help?
If you have questions about claim outcomes, our claiming support specialist are best placed to assist and can be reached on:
Phone: 1300 838 457
Email: hello@gaponly.com.au