Kaelo Health – MyHealth Application and Amendment Form

Kaelo Health - MyHealth Application and Amendment Form

Application Status
Policyholder Details
Dependant Details
Broker Details
Additional Documents
Declaration

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Applications received after the 15th of the current month will only activate the 1st of the following month.

Please indicate the status of your application by selecting the relevant option below *

New Application

Amendments to an Existing Policy

Cover Start Date *

Amendments to An Existing Policy

Policy Number *

For all amendments / updates please complete the relevant section that you are amending as well as completing the Broker Details Section and the Declaration Sections.

If you are human, leave this field blank.

OR Download Offline Form

Kaelo Risk (Pty) Ltd is an authorised financial services provider (FSP: 36931).
This product is underwritten by Centriq Insurance Company Limited (FSP 3417).

Statutory notice:

This is not a Medical Scheme and the cover is not the same as that of a Medical Scheme. This Policy is not a substitute for Medical Scheme membership.