Buy Medical GapCover online »
I warrant that the information provided to the insurer in connection with the policy, whether in my own handwriting or not, is true and correct.
I, the undersigned, hereby declare:
Although I applied for the policy through the Internet I acknowledge and appoint Optivest Health Services (FSP no. 13475) as intermediary to provide ongoing Intermediary services to me regarding this policy. I agree that the insurer may pay commission to the intermediary in terms of the Short-term Insurance Act 53 of 1998.
I understand and agree that: