Insurance Claim Form

Legal Expense:

A. POLICYHOLDER DETAILS

I understand that Legal Guardians and/or Monarch Insurance Company Limited shall not be liable for any fees for any Attorney, unless a written Confirmation of Cover is issued by Legal Guardians.

Legal Guardians and Monarch Insurance Company Limited (MICL) are committed to protecting your privacy. By providing your personal information, you consent to your information being collected in order to gain access to our products and services. Your information will be used properly, lawfully, securely, and transparently for the purpose for which it is intended, namely, the administration and further maintenance of your insurance product/s.

You are also consenting that Legal Guardians and MICL may use your information to contact you regarding changes or updates about your insurance product/s and that we may use your information in improving our product offering. If you do not want to receive any future product or service offerings from us, then inform us by contacting our offices on 010 446 8449.

B. DETAILS OF THE MATTER

PLEASE ENSURE THAT ALL SUPPORTING DOCUMENTATION IS SUBMITTED WITH THE COMPLETED APPLICATION FORM.

Legal Expense Cover Claim form – v01_112023