• PAWesome, you are one step closer to becoming part of the PawPaw pet family

    Understanding the next steps:

    1. This is an application for your pet to join PawPaw Pet Health Insurance, the policy will incept on the 1 st day of the following month. You have 14 days from receipt of your policy documents to cancel from inception date should you not wish to proceed with the cover, thereafter the cancelation period is 30 days written notice.
    2. This information is needed to provide upfront underwriting terms (Based on the information provided we may request additional medical history of your pet for underwriting purposes)
    3. PawPaw is a product distributed through Brokers, please select one of our Pet Expert Brokers to represent you - NO EXTRA COST to you as the policyholder
    4. Once the form is completed, you will receive notification confirming your request for insurance
    5. DONE 

  • POLICYHOLDER DETAILS

  • DETAILS OF THE PET/S TO BE INSURED

    • Pet 1 Details 

    • *EXCESS OPTION DETAILS

      OPTION 1
      Standard Excess : 15% excess minimum R500 per claim
      MRI/CT Scans : MRI/CT-Scans will carry an excess of R1000.00 PER SCAN (Plus any other excess/es applicable to the claim).
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 2
      Standard Excess : 15% excess minimum R250 per claim
      All gastro-intestinal related conditions excess: All gastro- intestinal related conditions claims will carry 15% excess, with a minimum of R500.00 per claim.
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 3
      Standard Excess : Flat Excess of R1000.00 per claim.
      MRI/CT-Scans: MRI/CT-Scan excess of R1000.00 per scan.

      ACCIDENT PLAN - OPTION 4
      Standard Excess : All claims will carry 15% excess, with a minimum of R250.00 per claim.
      Click here for the policy wording.

    •  - -
    •  - -

    • MEDICAL HISTORY

      Thank you for your enquiry. Below we will be asking you a few quick questions around any health problems, that the pet you wish to place on cover, may have. Please take care to answer these questions fully and correctly, in order for us to be able to give you an accurate quotation, based on the information you provide. We will be retrieving a full veterinary history when you put in your first claim for your pet. If there are any pre-existing conditions that you have not let us know about, this could result in us placing endorsements on your policy or your policy being cancelled.
    • Pet 2 Details (optional) 
    •  - -

    • *EXCESS OPTION DETAILS

      OPTION 1
      Standard Excess : 15% excess minimum R500 per claim
      MRI/CT Scans : MRI/CT-Scans will carry an excess of R1000.00 PER SCAN (Plus any other excess/es applicable to the claim).
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 2
      Standard Excess : 15% excess minimum R250 per claim
      All gastro-intestinal related conditions excess: All gastro- intestinal related conditions claims will carry 15% excess, with a minimum of R500.00 per claim.
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 3
      Standard Excess : Flat Excess of R1000.00 per claim.
      MRI/CT-Scans: MRI/CT-Scan excess of R1000.00 per scan.

      ACCIDENT PLAN - OPTION 4
      Standard Excess : All claims will carry 15% excess, with a minimum of R250.00 per claim.
      Click here for the policy wording.

    •  - -

    • MEDICAL HISTORY

      Thank you for your enquiry. Below we will be asking you a few quick questions around any health problems, that the pet you wish to place on cover, may have. Please take care to answer these questions fully and correctly, in order for us to be able to give you an accurate quotation, based on the information you provide. We will be retrieving a full veterinary history when you put in your first claim for your pet. If there are any pre-existing conditions that you have not let us know about, this could result in us placing endorsements on your policy or your policy being cancelled.
    • Pet 3 Details (optional) 
    •  - -

    • *EXCESS OPTION DETAILS

      OPTION 1
      Standard Excess : 15% excess minimum R500 per claim
      MRI/CT Scans : MRI/CT-Scans will carry an excess of R1000.00 PER SCAN (Plus any other excess/es applicable to the claim).
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 2
      Standard Excess : 15% excess minimum R250 per claim
      All gastro-intestinal related conditions excess: All gastro- intestinal related conditions claims will carry 15% excess, with a minimum of R500.00 per claim.
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 3
      Standard Excess : Flat Excess of R1000.00 per claim.
      MRI/CT-Scans: MRI/CT-Scan excess of R1000.00 per scan.

      ACCIDENT PLAN - OPTION 4
      Standard Excess : All claims will carry 15% excess, with a minimum of R250.00 per claim.
      Click here for the policy wording.

    •  - -

    • MEDICAL HISTORY

      Thank you for your enquiry. Below we will be asking you a few quick questions around any health problems, that the pet you wish to place on cover, may have. Please take care to answer these questions fully and correctly, in order for us to be able to give you an accurate quotation, based on the information you provide. We will be retrieving a full veterinary history when you put in your first claim for your pet. If there are any pre-existing conditions that you have not let us know about, this could result in us placing endorsements on your policy or your policy being cancelled.
    • Pet 4 Details (optional) 
    •  - -

    • *EXCESS OPTION DETAILS

      OPTION 1
      Standard Excess : 15% excess minimum R500 per claim
      MRI/CT Scans : MRI/CT-Scans will carry an excess of R1000.00 PER SCAN (Plus any other excess/es applicable to the claim).
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 2
      Standard Excess : 15% excess minimum R250 per claim
      All gastro-intestinal related conditions excess: All gastro- intestinal related conditions claims will carry 15% excess, with a minimum of R500.00 per claim.
      Penalty excess (when no preauthorised is given): All claims in terms of 1.1.2 (What we cover) not preauthorized will carry an additional excess of 20%, with a minimum of R500.00 for each claim not pre-authorized.

      OPTION 3
      Standard Excess : Flat Excess of R1000.00 per claim.
      MRI/CT-Scans: MRI/CT-Scan excess of R1000.00 per scan.

      ACCIDENT PLAN - OPTION 4
      Standard Excess : All claims will carry 15% excess, with a minimum of R250.00 per claim.
      Click here for the policy wording.

    •  - -

    • MEDICAL HISTORY

      Thank you for your enquiry. Below we will be asking you a few quick questions around any health problems, that the pet you wish to place on cover, may have. Please take care to answer these questions fully and correctly, in order for us to be able to give you an accurate quotation, based on the information you provide. We will be retrieving a full veterinary history when you put in your first claim for your pet. If there are any pre-existing conditions that you have not let us know about, this could result in us placing endorsements on your policy or your policy being cancelled.
    • Collapse Stopper 

  • THE POLICIES ISSUED AND THE PREMIUMS PAYABLE

  • PLEASE NOTE: you have the option to pay your premium annually. If you select this option, one of our friendly consultants will be in touch with you to set that up.

  • FINAL CALCULATION

  • The following segment is optional.
    Should you simply require a quote, skip this segment and we'll capture your banking details at a later stage once you wish to proceed with cover and incept the policy.

  • BROKER SELECTION

  • AUTHORITY TO DEBIT ACCOUNT

  • I request and authorise Renasa Insurance Co Ltd to draw against the above mentioned account, the amount necessary for
    payment of the monthly premium, as and when, required. This amount will debit every month until this arrangement is
    cancelled in writing by either party.
    I accept that, if the debit date falls on a weekend, I will be debited on the subsequent working day. If no debit date is selected
    P.UMA reserves the right to select the last working day of each month.

  • DECLARATION
    I hereby confirm that all details supplied above are true and correct to the best of my knowledge. NB: Any false disclosure could result in the policy being made void. This policy will be renewed on 1 June each year. You will be informed of any changes 30 days prior to renewal.

     

    By signing below, I hereby accept all terms and conditions (available by clicking here) related to this policy and authorise the premium to be debited off my account. 

    By completing this application form you consent to us obtaining any veterinary histories required from your treating vets in order for us to underwrite this risk. All your information will be treated in the strictest confidence at all times.

  • Clear

  • CLIENT VALIDATION BY ELECTRONIC SIGNATURE

  • These are important documents & should be kept for reference purposes. A copy of the details entered will be sent to us for processing, and a reference copy will be emailed to you (at the email address you've entered) for your records.

  • Should be Empty: