Senior Citizens (65 - 84 Years) Funeral Plans Pensioners Funeral Plan R90 PM* Single member (65 - 74 years) Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Main Member R10 000 R15 000 R20 000 R25 000 R30 000 Premiums R90 pm* R150 pm* R180 pm* R200 pm* R250 pm* FUNERAL PLAN R10 000 @ R90 pm* R15 000 @ R150 pm* R20 000 @ R180 pm* R25 000 @ R200 pm* R30 000 @ R250 pm* Single member (75 - 79 years) Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Main Member R10 000 R15 000 R20 000 R25 000 R30 000 Premiums R150 pm* R200 pm* R250 pm* R270 pm* R310 pm* FUNERAL PLAN R10 000 @ R150 pm* R15 000 @ R200 pm* R20 000 @ R250 pm* R25 000 @ R270 pm* R30 000 @ R310 pm* Single member (80 - 84 years) Plan 1 Plan 2 Plan 3 Plan 4 Plan 5 Main Member R10 000 R15 000 R20 000 R25 000 R30 000 Premiums R220 pm* R270 pm* R300 pm* R330 pm* R370 pm* FUNERAL PLAN R10 000 @ R220 pm* R15 000 @ R270 pm* R20 000 @ R300 pm* R25 000 @ R330 pm* R30 000 @ R370 pm* Click here for policy provisions: Policy Provisions Leave this field blank Name & Surname of the Beneficiary Cell Number +27 E-mail Address Your ID Number Age (18 or above) Are you the premium payer? Yes No Occupation: Employed Unemployed Student Residential Address Zip Code Province: Eastern Cape Free State Gauteng Kwa-Zulu Natal Limpopo Mpumalanga Northern Cape North West Name of the life insured (Senior Citizen) Surname Age 18 - 64 Years 65 - 74 Years 75 - 79 Years 80 - 84 Years Gender Male Female ID Number (Senior Citizens) Cover Amount R10 000 R15 000 R20 000 R25 000 R30 000 I have read and agree with the policy provisions. Yes No Method of Payment Debit-Order Assistance Services (Repatriation, EMS, R200 Airtime, Tele Health Advice etc.) @R20 Yes No Submit
