Funeral Quote

Quote and Policy Application

Simply complete these steps to get an instant quote now and buy a policy

Mobile Verification

Sales Consultant Details

Personal Details

Cover Selection

Quote Summary

Additional Members

Payment Details

Beneficiary

Confirmation

Step 1 of 9

Mobile Verification

Mobile Number *

Enter your South African mobile number (e.g., 0821234567, 27821234567, or +27821234567)

Are you a BBB Sales Force Member?

Yes, I am a BBB Sales Force Member No, I am not a BBB Sales Force Member

Were you referred by a BBB Sales Force Member?

Yes, I was referred No, I was not referred

Sales Force Member Linking Required

All policyholders must be linked to a Botle Buhle Brands Sales Force Member. No worries, we'll link you to a Consultant near you! Please provide your address details below.

Province *

About You - Main Member

Please provide your personal information for the quote application

ID Number *

0/13 digits

First Name(s) *

Surname *

POPIA Consent

By checking this box, you consent to the processing of your personal information in accordance with the Protection of Personal Information Act (POPIA). Your information will be used solely for the purpose of processing your quote and providing you with our services.

I acknowledge that I have read and understood the POPIA consent and agree to the processing of my personal information

Cover Selection

Choose your preferred cover amount and view the monthly premium

Age

years old

Age Bracket:

Select Cover Amount *

Quote Summary

Review your quote details and add additional members if needed

Main Member Details

Total Monthly Premium:

Do you want to add additional members?

You can add up to 31 additional members to your policy

Debit Order Details

Please provide your banking details for the monthly premium deductions

Account Holder Name *

Bank Name *

Account Number *

Account Type *

Debit Order Day *

DEBIT ORDER ACCEPTANCE

I, [Customer Name], authorise Phakama Administration Services on behalf of Asuer Financial Services and Guardrisk Life, to debit my account for my Asuer Funeral Cover premium payment of R0.00 on the [date] of each month. I note that the payment reference as registered with the bank will appear on my bank account as: ASUER_FUN followed by my policy number. I understand I can cancel this at any time.

I have read and accept the above debit order mandate

Beneficiary Details

Would you like to add a beneficiary now? This will help us pay out in the event of a claim on your policy as quickly as possible. This step can be skipped.

First Name *

Surname *

Date of Birth

Required if ID number is not provided

ID Number

Optional: Provide ID number if date of birth is not available

Relationship to Main Member *

Contact Number

Note: You can only nominate one beneficiary at this time. The beneficiary will receive 100% of the cover amount in the event of a valid claim. This step is optional and you can add or update your beneficiary information later by contacting our customer service team.

Confirmation

Review your application summary and confirm that you understand the terms and conditions before submitting

Terms and Conditions

In order to get covered, you'll need to agree and accept our Privacy Policy and Terms & Conditions which you can access here: https://asuer.co.za/terms-conditions. Please go through them and confirm that you understand and agree.

I confirm that I have read and understood the terms and conditions

Signature

By providing your details below, you are electronically signing this application

First Name *

Surname *

Name fields are auto-filled from your personal details

Date *