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Funeral Insurance Application

Janifam Brokers (Pty) Ltd - Reg No: 2021/574770/07

1
Personal Info
2
Policy Details
3
Dependents
4
Documents

Personal Information

Tell us about yourself

Residential Address

Policy Details

Choose your package and cover

📈 Live Premium Calculator
Select your category, package, and enter your ID number to calculate your premium

Dependents & Beneficiary

Add family members to your policy

Dependents

No dependents added yet.

Extended Family Members

No extended family members added yet. Extended members have their own premium rate.

Beneficiary

📈 Live Premium Calculator
Complete Policy Details to see your premium

Documents & Submission

Upload supporting documents and submit your application

Required Documents

You can upload documents now, or submit your application first and deliver them to your agent or our office. Pending documents will be tracked on your profile. You can also send documents via WhatsApp to 071 354 6288 or email to info@janifambrokers.co.za

📄
Copy of ID - Policy Holder Required
Clear copy of your South African ID document
📄
Copy of ID - Beneficiary Required
ID copy of the policy beneficiary

Application Summary

Applicant -
Package -
Category -
Cover Amount -
Monthly Premium -
Payment Date -
🔒 Privacy & POPIA Consent Version 1.0

By submitting this application, you confirm that the information provided is true and correct, and you consent to Janifam Brokers (Pty) Ltd collecting and processing your personal information for the purpose of providing funeral insurance services, in accordance with the Privacy Policy (POPIA) Version 1.0.