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Forms

Beneficiary nomination forms

Death Benefits

We have simplified the death claims process and requirements. For a claim following the death of a South African citizen, we no longer require certain documents, such as death certificates and copies of ID documents.

For more details refer to our Smart Claims brochure.

Disability Benefits

Please submit all the required information as soon as possible for proactive claims management and speedy decisions on claims.

For more details and answers to FAQs, refer to our disability claims handbook.

We understand that it takes time to collate all required documentation and information. You can submit this claim notification form while you gather the supporting documentation.
Disability claim - Potential claim notification (pdf)

Please include the following supporting documents with your disability claim forms:

  • All clinical investigations and diagnostic test results.
  • Any additional and available medical reports.
  • Your leave records for the past two years.
  • Your identity document (if you have a new ID card, send us copies of both sides).
  • Your payslip at the date of disability.
Disability claim - Employer declaration (pdf)
Disability claim - Employee declaration (pdf)
Disability claim - Confidential medical report (pdf)
Disability claim - Consent form (pdf)

Please include the following supporting documents with the accidental disability claim forms:

  • All clinical investigations and diagnostic test results.
  • Any additional and available medical reports.
  • Your identity document (if you have a new ID card, send us a copy of both sides).
  • Your payslip at the date of disability.
Accidental disability claim - Employer/Employee declaration (pdf)
Accidental disability claim - Confidential medical report (pdf)

Please include the following supporting documents with the spouse disability claim forms:

  • All clinical investigations and diagnostic test results.
  • Any additional and available medical reports.
  • Main member’s payslip at the date of spouse’s disability.
  • Job description (if spouse is employed).
  • Copy of leave records for the past 2 years (if spouse is employed).
  • Copy of marriage certificate (if a registered marriage).
Spouse disability benefit – application form (pdf)
Spouse disability benefit – confidential medical report (pdf)

Illness Benefits

Please include the following supporting documents with the Critical Illness claim form:

  • All clinical investigations and diagnostic test results.
  • Any additional and available medical reports.
  • Your identity document (if you have a new ID card, send us copies of both sides).
  • Your payslip at the date of diagnosis.
Critical Illness - Employer/Employee declaration (pdf)
Critical Illness - Confidential medical report (pdf)
Critical Top-up - Employer/Employee declaration (pdf)
Critical Top-up - Confidential Medical Report (pdf)
Critical Illness - Consent Form (pdf)

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