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Debit Order Mandate

By accepting this mandate, you authorise Comfort Insurance and its nominated service providers to collect the agreed premium from the bank account above on the selected debit-order day. You confirm that the account details are correct, that you are authorised to use the account, and that this authority remains in place until cancelled in accordance with your policy terms. You may query an unauthorised debit order with your bank within the applicable banking time limits.

1. Nature of This Policy

This is a funeral insurance policy underwritten by a registered South African insurer and brokered by Comfort Insurance. The benefit is payable solely upon the death of a covered member. This policy does not accumulate a cash value, surrender value, or any savings or investment component.

2. Accuracy of Information

I confirm that all information provided throughout this application is true, complete, and accurate to the best of my knowledge. I understand that any misrepresentation, non-disclosure, or omission of material facts — whether intentional or not — may result in my claim being repudiated, my policy being cancelled, or both.

3. Waiting Periods

I acknowledge that a waiting period applies to natural death claims from the policy inception date. No waiting period applies in the event of accidental death. Extended Family members are subject to a separate 6-month waiting period from the date they are added.

4. Premium Obligations

I understand that premiums are due on the agreed debit date each month. A grace period of 30 days applies. Should my policy lapse due to non-payment, reinstatement may be subject to a new waiting period.

5. Cooling-Off Period

I have been informed of my right to cancel this policy within 31 days of the policy inception date without penalty, provided no claim has been submitted or is pending.

6. Personal Information & POPIA

I consent to Comfort Insurance collecting, processing, and storing my personal information — including banking and identification details — in accordance with the Protection of Personal Information Act 4 of 2013 (POPIA).

7. Verification Consent

I authorise Comfort Insurance to verify my personal information, identification, and banking details with relevant third parties — including credit bureaus, banks, and the Department of Home Affairs — where necessary to process this application.

8. Complaints & Regulatory Rights

I am aware that should I have a complaint that cannot be resolved directly with Comfort Insurance, I have the right to escalate to the FAIS Ombud or the Ombudsman for Long-term Insurance.

9. Governing Law

This application and the resulting policy are governed by the laws of the Republic of South Africa.

10. Acceptance

By ticking the box below and signing with my full name, I confirm that I have read, understood, and agree to all of the above, and that all information provided in this application is correct and complete.