Application Form

Your privacy is of utmost importance to us. We will take the necessary measures to ensure that any and all information, prov ided by you for the purpose of this application, is processed in accordance with the provisions of the Protection of Personal Information Act 4 of 2013 and further, is stored in a safe and secure manner. You hereby agree to give honest, accurate and up-to-date Personal Information in order to process and accept this application. You accept that your Personal Information collected by Us may be used for the following reasons: 1. To establish and verify your identity in terms of the Applicable Laws: 2. To enable Us to proceed to issue the Policy should we accept this application; Unless consented to by yourself, we will not sell, exchange, transfer, rent or otherwise make available your personal Information (such as your name, address, email address, telephone or fax number) to any other parties and you indemnify Us from any claims resulting from disclosures made with your consent. You understand that if the Administrator/Insurer has utilised your Personal information contrary to the Applicable Laws, you have the right to lodge a complaint, with Guardrisk or with the Information Regulator.