PawPaw Pet Insurance Mobile Friendly Application Form
Your broker is G Van Cuyck Insurance Consultants FSP No 12925
Unit B16, Pinelands Business Park, New Mill Rd, Pinelands, Cape Town, 7405
T 0215315882

PawPaw is administered by P.UMA on behalf of Renasa Insurance Company
Insurer: Renasa Insurance Company Ltd - Reg. No. 1998/000916/06 - VAT No. 4290173253 - FSP No. 15491
Underwriting Manager: P.UMA - Reg. No. 2011/107009107 - VAT No. 4280260425 - FSP No. 44387

Email address *
Mobile Friendly Application Form
Select Your Pet *
Breed Type
Your answer
What is your pet's name? *
Your answer
Is your pet sterilized? (Neutering is the process of removing your pet's ability to reproduce. It is also called spaying or castrating. Your answer will not affect your premium.)
What gender is your pet?
Date of birth (Please note that we only insure pets over the age of 8 weeks. If you are unsure about the exact date of birth of your pet then please select an approximate date)
MM
/
DD
/
YYYY
Does this pet currently have all its vaccinations up to date?
Veterinary Clinic your dog is registered at
Your answer
Vet Practice Phone
Your answer
1. Has this pet ever been to the veterinarian for any medical problems?
2. Has this pet needed medical treatment now or in the past? *
3. Is this pet currently on any medication or prescription food? *
4. Has this pet ever exhibited excessive licking or scratching? *
5. Has this pet ever had any eye or ear problems? *
6. Has this pet ever had severe vomiting or diarrhoea? *
7. Does this pet have difficulty walking? *
8.Does this pet have any physical abnormalities? *
9. Has the pet had any behavioural problems? *
10. Are all vaccinations up to date? *
11. Has this pet ever been used in competitive or commercial activities? *
12. Is your pet adopted / rescued, if yes pls provide the date. *
If you answered yes to any of the questions above, please explain more details.
Your answer
Please read this carefully
WHAT IS PAWPAW?
PawPaw is an insurance product designed to cover the unexpected veterinary costs that pet cats or dogs may incur as the result of illness or injury. PawPaw is underwritten by RENASA INSURANCE COMPANY LTD. and administered by PET UNDERWRITING MANAGING AGENCY PTY LTD (P.UMA). In return for paying your premium, RENASA INSURANCE COMPANY LTD. will cover the pet cat or dog named in the overleaf policy schedule for the cost of fees incurred as the result of veterinary treatments for illness and injury.

WHO CAN JOIN?
Any pet cat or dog older than 8 weeks and younger than 8 years that is kept as a household pet in the RSA. All vaccinations must be up to date at the time of joining.

GENERAL REQUIREMENTS
This policy will incept on the first day of the next calendar month following the acceptance of the application. The policy terms and premiums payable will be reviewed on the 1 June each year. The premiums are subject to inflation.
There is an excess fee of 10% for every claim with a minimum of R200 per claim that you must pay.
All non-emergency treatments must be pre-authorised by P.Uma.
You agree to disclose all information relating to your pets health and condition at the time of signing up for cover and thereafter. Failure to do so could result in cancellation of your policy due to-non disclosure.
You must notify P.Uma of any emergency treatments within 72 hours of the event.
All claims must be submitted to P.Uma within 60 days of the date of treatment.
P.UMA pays claims in accordance with the South African Veterinary Councils Guideline of Tariffs and reserves the right to request a second opinion from a vet of our choice regarding treatment and fees charged. If the fees are deemed excessive or the treatment deemed inappropriate we will pay the lesser amount with the balance being for your account.
P.UMA reserves the right to refuse payment for repeated treatments if they are, under advice, deemed as ineffective or likely to cause the cat/dog undue distress.
As the person responsible for the cat/dog you are expected to take all reasonable steps to prevent injury and illness. Failure to do so may result in rejection of claims and/or the cancellation of this policy.
If there is another insurance policy covering the same claim, only the rateable proportion of that claim will be paid in terms of this policy.
This policy may be terminated upon giving a one month written notice of cancellation and the cancellation shall be effective from the first day of the calendar month following the notice.

WHAT WE COVER
1. PawPaw covers the cost of veterinary treatments required to appropriately treat illness or injuries that the insured pet may suffer. The treatments covered include, but are not limited to:

a. Consultation, acute medication, initial diagnostics, x-rays, biopsies and tests

b. Rehabilitation (post-operative only) treatments, specialist referrals, further diagnostic workups, blood tests, MRI / CT scans, radiology, radiation / chemotherapy, surgeries, chronic medication and prosthesis requires pre-approval and is subject to case management and clinical protocols. P.uma will require a detailed treatment plan from the treating Vet.

2. Chronic treatment plans may be purchased at an additional premium as a complement to this insurance plan. Chronic treatment plans are subject to treatment protocols (appropriate treatment plans) as determined and approved by P.uma (under the guidance of our Vet). A detailed treatment plan must be submitted by the treating Vet for approval by P.uma.

3. The PawPaw lifestyle benefit will pay for the cost of cremation up to a maximum of R1,000.00 for your pet. This amount will only be paid on receipt of a valid invoice from the Crematorium or Vet.

4. The PawPaw lifestyle benefit will pay up to a maximum of R 600.00 towards, either, a health check-up OR puppy socialization classes. . This amount will only be paid on receipt of a valid invoice from the relevant service provider. This benefit is available once per policy year.

5. Your pet is immediately covered for accidental injuries, as long as the policy has incepted

WHAT WE DO NOT COVER
1. The treatment of pre-existing conditions, including any condition that manifests during any waiting period (If your pet is diagnosed with any illness/condition or a pre-existing injury is noted within the waiting period, these will become full exclusions on the policy).
2. P.UMA reserves the right to refuse payment for repeated treatments if they are, under advice, deemed as ineffective, excessive or likely to cause the pet undue distress.
3. Any costs other than the costs of veterinary treatments for the pet listed on the policy.
4. The costs for the treatment of any illness within the first 30 days of joining PawPaw. (The costs of treatments for trauma resulting from accidental injury are covered in this period).
5. Any invoices submitted more than 60 days after the date of treatment.
6. The costs for any treatments for injuries and illness incurred outside of the Republic of South Africa.
7. Any injury caused by abuse or negligence. We will report all abuse to the relevant authorities.
8. Any treatment that continues for longer than 3 months unless approved by P.UMA and subject to clinical protocols.
9. Any complementary treatments, experimental treatments or any treatments not forming part of mainstream veterinary science, including but not limited to acupuncture, physiotherapy, homeopathy, hydrotherapy, rehabilitation care (if not post-surgery and pre-approved).
10. The treatment of behavioral disorders.
11. Any routine care such as vaccinations, dental scale and polish, anal gland expression, de-worming, grooming, tick and flea control or any food costs.
12. Any elective or cosmetic treatments.
13. Any treatments in connection with pregnancy, birthing and fertility and breeding (any complications suffered as a result as one of these), sterilization, artificial insemination and injuries resulting from breeding.
14. House calls, travel costs, after-hours consultation or hospitalisation unless a vet confirms it as necessary in terms of the pet's health.
15. Any surgical items that can be used more than once. These are non-chargeable items.
16. The costs of any prosthesis, implants or transplantation unless explicitly approved by P.UMA.
17. Any costs after death (post mortem examinations).
18. Any treatment by person/s not registered with the South African Veterinary Council.
19. We do not under any circumstance cover euthanasia unless recommended by a veterinarian.
20. Any non-emergency treatment undertaken without the prior approval of P.UMA.

By ticking the box below I agree to the above Terms & Conditions *
Required
Policy Holder Details
In order for us to process your application, please provide your information.
First Name
Your answer
Last Name
Your answer
ID Number
Your answer
Phone
Your answer
Physical Address
Your answer
Postal Address
Your answer
Postal Address
Your answer
Account Holder Name
Your answer
Account Number
Your answer
Cheque or Savings Account
Bank Name
Your answer
Branch Code
Your answer
Debit Day *
Debit Order Authority
I request and authorise Renasa Insurance Co Ltd to draw against the above mentioned account, the amount necessary for
payment of the monthly premium, as and when, required. This amount will debit every month until this arrangement is
cancelled in writng by either party.
I accept that, if the debit date falls on a weekend, I will be debited on the subsequent working day. If no debit date is
selected P.UMA reserves the right to select the last working day of each month
By ticking the box below, I hereby accept all terms and conditions related to this policy and authorise the premium to be debited off my account *
Required
You are covered by the best in the industry
Broker : GVC Brokers FSP12925
Insurer : Renasa Insurance Company Ltd - Reg. No. 1998/000916/06 - VAT No. 4290173253 - FSP No. 15494
Underwriting Manager: Pet Underwriting Managing Agency - Reg. No. 2011/107009107 - VAT No. 4280260425 - FSP No. 9844
Contact Us for PawPaw Pet Insurance
GVC Brokers
Unit B16, Pinelands Business Park, New Mill Rd, Pinelands, Cape Town, 7405
PO Box 38692, Pinelands, Cape Town, 7430
T 021 531 5882
For Pre-Authorisations please call 021 403 9177
C 082 464 9146 (Pet Insurance Emergencies and A/H support)
F 021 531 5855
E insurance@pethealthcare.co.za
Thank you for your application
We treat personal information as private and confidential (even when you are no longer a client). None of your details will be disclosed to anyone. GVC Brokers (FSP 12925)
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