SUBMIT YOUR CLAIM HERE

Before continuing, ensure that you take clear photos of the following documents.

 
 
 

* Click on Choose File button to upload a new file or to replace already uploaded file.

 

CLAIMANT'S DETAILS

 
Are you the appointed beneficiary?
Yes No
 

DECEASED'S DETAILS

 
 

NOMINATE NEW BENEFICIARY (To be completed by main member ONLY if a deceased dependent is also the beneficiary)

 
Are you the Main Member?
Yes No
 
 

DETAILS OF FUNERAL PARLOUR

 
 
 

BANK DETAILS - CLAIMANT

 
 
Sign inside the grey box using a mouse, your finger or a stylus. If you make a mistake or want to redo your signature then click the Reset button or Undo last stroke button. After that you must click on Preview and then Submit if you are happy with your signature. Please do not click on Submit before you have clicked Preview after signing or resigning.