Funeral Cover Calculator | Bright Harbour

Affiliated with Assupol

1Select an option

2Add a your self

3Add Spouse and Children under the age of 21

4Add you Parrents & In-laws

5Other Dependants & Children over 21

6 Summary of your chosen benefits

7Personal Details

8Contact Details

9Your Employment Details

10About your Beneficiary

Who would you like to get funeral cover for

My self

My Spouse and Children

My Parents & In-laws

Other Dependants & Children over 21

Add your own funeral cover

Only one main member can be added.

Main Member (For Yourself)

Name	Date of Birth	Age	Choose Cover Amount	Monthly Premium	Actions

There are no Main Member.

Maximum number of main member reached.

Main Member

Grand Total

Please add your Spouse and Children under 21 below

Spouse and children under 21

Relationship	Name	Age	Date of Birth	Choose Cover Amount	Monthly Premium	Actions

There are no Spouse and children under 21.

Maximum number of spouse and children under 21 reached.

Total for Spouse and children under 21

Grand Total

Please add your Parents and In-laws below

For Parents & Parents-in-law

Relationship	Name	Age	Date of Birth	Choose Cover Amount	Monthly Premium	Actions

There are no Parents & In-laws.

Maximum number of parents & in-laws reached.

Total for Parents & Parents-in-law

Grand Total

Other Dependants & Children over 21

Name	Age	Date of Birth	Choose Cover Amount	Monthly Premium	Actions

There are no Dependants & Children over 21.

Maximum number of dependants & children over 21 reached.

Total for Other Dependants & Children over 21

Grand Total

Summary of your chosen benefits:

Main Member
{Nested Form:5:filter[26,9,31]}

Spouse & Children Under 21
{Nested Form:1:filter[28,26,9,29]}

Parents & In-laws
{Nested Form:3:filter[28,26,9,29]}

Other Dependants & Children Over 21
{Nested Form:51:filter[28,26,9,30]}

Grand Total

Free Benefits included in your premium:
- Cover for stillborn children, and for newborn children for their first three months
- Instant accidental death cover of R5 000 for all lives insured from acceptance date to the start of the policy
- Premium Waiver - Death – guaranteed insurance for your family, without them having to pay any premiums for five years after your death
- Assupol On-Call: Tutor assistance to children, Trauma counselling & Transport of the deceased & Family to the place of the funeral

If you are satisfied with your chosen cover and the total premium, click “next” to continue with an official online application.

About You

Full Name(Required)

Full First Name Surname

ID Number(Required)

Marital Status(Required)

Education(Required)

Home Language(Required)

Ethnic group(Required)

Your Contact Details

Tel (Home)(Required)

Cellphone(Required)

Email(Required)

Address(Required)

Street Address City Province ZIP / Postal Code

Postal Address(Required)

Postal address is the same as street address

Yes

Postal Address

P.O.Box Number and Suburb City or Town Province Postal Code

Your Employment Details

Name Of Employer(Required)

Main Occupation(Required)

Work Cellphone

Work Telephone

Work E-mail

Gross Monthly Income:(Required)

Employment Sector(Required)

Persal Number(Required)

Your Bank Details Details

Name of Bank(Required)

Account Number(Required)

Branch Name(Required)

Branch Code(Required)

Account Type(Required)

Monthly Deduction Date(Required)

Preferred start date (i.e.: 1dt premium deduction date)

Day

Month

Year

Identity Information

Please upload a front facing selfie of yourself(Required)

Max. file size: 2 MB.

Please upload a copy of your ID book(Required)

Max. file size: 4 MB.

About Your Beneficiary

Nominate Estate?(Required)

Yes

The family member you appoint to claim & receive the policy benefits, should you pass away. (Must be age 18 or older)

Full First Names(Required)

Surname(Required)

Initials(Required)

Relationship to you(Required)

Title(Required)

Gender(Required)

Date of Birth(Required)

DD slash MM slash YYYY

Cellphone(Required)

Add your own funeral cover

Please add your Spouse and Children under 21 below

Please add your Parents and In-laws below

Other Dependants & Children over 21

About You

Your Contact Details

Your Employment Details

Your Bank Details Details

Identity Information

About Your Beneficiary

Need advice on your Retirement or Investments?

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