Agent Hub | FamilyEasy

Start a Sale

Verify your representative profile to begin a new application.

Step 1 of 8

Representative Verification

Verify your representative profile

Enter the cellphone number registered on your InsureEasy representative profile.

Registered Cellphone Number *

Start New Policy

Select a product

Choose the product you would like to sell to this client.

Representative Verified

Representative Verified Representative

Reference -

Cellphone -

Funeral Insurance
Funeral cover is issued under the Linar funeral product journey.

RapidCare
RapidCare provides access to Accisure road-accident assistance and facilitation services.

Funeral Insurance Continue with the existing FamilyEasy funeral application process.

RapidCare Register a standalone RapidCare member for road accident support services.

RapidCare

Member details

Capture the details of the person who will be registered for RapidCare.

First Name *

Surname *

Identity Type *

Identity / Passport Number *

Upload Copy of ID *

Upload a clear PDF, JPG or PNG copy of the member's South African ID.

Cellphone *

Email Address *

Physical Address *

Province *

Postal Code *

RapidCare

Plan & payment

Select the RapidCare membership option and how the first monthly payment will be made.

RapidCare provides road-accident assistance and facilitation services through Accisure.

Important information

RapidCare is an assistance and facilitation service for qualifying road-accident incidents and is not medical insurance.

Access to private medical treatment is subject to the circumstances of the accident, applicable Road Accident Fund requirements and the terms of the relevant service providers.

Certain incidents may be excluded, including accidents outside South Africa, criminal activity and circumstances where the member's liability may prevent qualification.

RapidCare Plan *

Main — R49 / month Main member only

Main + 1 — R79 / month Main member plus 1 additional covered member

Family — R119 / month Main member plus up to 5 additional covered members

Driver — R149 / month Main driver plus up to 5 additional covered members

Monthly Premium

R 49.00

Who will pay the premium?

Full Name *

SA ID Number *

Cellphone *

Email *

Relationship *

Payment Method

Pay Online Now

Secure card payment through PayStack.

Pay Later with EasyPay

RapidCare

Covered members

Add the people who will be covered under this RapidCare membership. They do not have to be related to the main member.

Selected Plan

Plan -

Main Member -

Number of Additional Covered Members *

Additional members do not need to be related to the main member.

RapidCare

Review and submit

Application

Reference

Representative

RapidCare Membership

Member

Plan

Monthly Premium

Covered Members

Premium Payer

Payment Method

I confirm that the information provided is true and correct.

I understand that RapidCare is an assistance and facilitation service for qualifying road-accident incidents and is not medical insurance.

I understand that access to private medical treatment is subject to the circumstances of the accident, applicable Road Accident Fund requirements and the terms of the relevant service providers.

I understand that certain incidents are excluded, including accidents outside South Africa, criminal activity and circumstances where the member's liability may prevent qualification.

I consent to my personal, accident and medical information being used and shared where reasonably required to administer the RapidCare service.

I confirm that the applicable RapidCare terms and conditions have been explained to me and that I accept them.

Member Signature *

The RapidCare member must sign below to confirm the application, declarations and acceptance of the applicable service terms.

Signature required before submission.

Plan & Cover

Build funeral cover

Select the required FamilyEasy plan and cover.

Representative Verified

Representative Verified Representative

Reference -

Cellphone -

Which plan would you like? *

Member Only Main insured only, plus up to 4 optional extended family members.

Member + Children Main insured plus up to 6 children and up to 4 extended family members.

Member + Spouse Main insured plus one spouse and up to 4 extended family members.

Family Main insured, one spouse, up to 6 children and up to 4 extended family members.

Main Insured Age Band *

Funeral Cover *

R5 000

R10 000

R15 000

R20 000

R25 000

R30 000

Monthly Premium

R —

Main Insured

Main insured person

Capture the personal and contact details of the main insured person.

First Name *

Surname *

Identity Type *

Identity / Passport Number *

Cellphone *

Email Address *

Physical Address *

Province *

Postal Code *

Included Members

Plan members

Member Only

No spouse or children are required for this plan.

Spouse

First Name *

Surname *

Identity Type *

ID / Passport Number *

Children

Number of Children

Extended Family

Add extended family

All plans may add up to four extended family members.

Number of Extended Family Members

Beneficiary

Beneficiary details

First Name *

Surname *

Cellphone *

Relationship *

ID Type *

ID / Passport *

Premium & Payment

Who will pay the premium?

Full Name *

ID Number *

Cellphone *

Email *

Relationship *

Payment Method

Pay Online Now

Secure card payment through PayStack.

Pay Later with EasyPay

Total Monthly Premium

R —

Confirmation

Review and submit

Application

Reference

Representative

Policy

Main Insured

Plan

Cover

Spouse

Children

Extended Family

Monthly Premium

Payment Method

Beneficiary

Name

I confirm that the information provided is true and correct.

I confirm that all insured lives have consented to being insured.

I confirm that the applicable terms, conditions and waiting periods have been explained.

InsureEasy Brokers is an Authorised Financial Services Provider – FSP 53008.

InsureEasy Brokers

Phone Number

Contact Address

Email Address

Start a Sale

Verify your representative profile

Select a product

Member details

Plan & payment

Important information

Who will pay the premium?

Payment Method

Covered members

Review and submit

Application

RapidCare Membership

Build funeral cover

Main insured person

Plan members

Spouse

Children

Add extended family

Beneficiary details

Who will pay the premium?

Payment Method

Review and submit

Application

Policy

Beneficiary