START PERSONAL QUOTE.

To request a quotation from DekfaSure we will need your claim history for the last 3 years. The quotation will be based on all information supplied. Quotation subject to changes according to accuracy of information provided. By completing the following claim details form, you hereby confirm that all claim history provided is accurate.

The information you provide below allows Dekfasure to structure an individually-tailored short term Personal Insurance solution to meet you and your family’s needs. Please note that Dekfasure reserves the right to accept or decline your application upon consideration of the information provided.

Dekfasure respects that your personal information is confidential in nature. Your data will be processed by Dekfasure, its assessors and surveyors, and for contribution to the Insurance Data System, securely managed by the South African Insurance Association.

PLEASE NOTE: After you’ve submitted to form please confirm if there is a success message, otherwise fields in red will need to be filled in/corrected.

PERSONAL INFO:
Format: DD/MM/YYYY

TIME FRAME

TIME FRAME

CLAIMS:


CLAIM 1

Format: DD/MM/YYYY

LICENSE OBTAINED:
Format: DD/MM/YYYY
HOUSE CONTENTS:
BUILDING:

TIME FRAME

TIME FRAME

CLAIMS:


CLAIM 1

VEHICLES:

VEHICLE 1

(PRIVATE / BUSINESS / PROFESSIONAL)

(COMPREHENSIVE / LIMITED / 3RD PARTY)

EXTRAS:

(VSS / VESA 3/4 / TRACKER/ ANTI HIJACK)

MOTORBIKES:

MOTORBIKE 1

(PRIVATE / BUSINESS / PROFESSIONAL)

(COMPREHENSIVE / LIMITED / 3RD PARTY)

(VSS / VESA 3/4 / TRACKER/ ANTI HIJACK)

PERSONAL ACCIDENT:

PERSONAL ACCIDENT 1

PUBLIC LIABILITY:
PLIP:
CONTACT INFORMATION:

Need Assistance?

Need to know more about personal or business insurance? Tell us a bit about yourself and your specific requirements. We’re happy to answer any of your questions before you consider signing on the dotted line. Our team of insurance experts are always thinking of new ways to accommodate clients but we can’t do so without your valuable input. No query is too big or too small to us. Reach out today and put any fears to rest.