Follow the steps to successfully complete your claim form.

1. Click the ‘Get Form’ button to obtain the claim form and open it in an accessible format.
2. Begin by entering the policy number associated with the deceased’s insurance policy.
3. Provide your personal details as the claimant, including your surname, initials, ID number, relation to the deceased, and contact information.
4. Complete the section about the deceased, including their surname, initials, ID, date of death, street address before death, last occupation, and marital status.
5. If applicable, indicate if there were other policies on the life of the deceased by providing the policy numbers and names of the insurers.
6. Detail the circumstances of death, specifying if it was due to natural or unnatural causes and providing information about any related illnesses or causes.
7. Fill in the funeral details, including the undertaker's name, date of funeral, and street address where the funeral will take place.
8. Provide your banking details, ensuring to include the name of the bank, account type, account number, and the type of account you prefer for receiving the benefits.
9. Sign the declaration at the end of the form, confirming all information is accurate and authorizing Assupol to seek further information if necessary.
10. After completing the form, you can save changes, download, print, or share the document for submission.

Take the next step to finalize your claim by completing the Assupol Death Claim Form online.