Skip to main content

ProVérte – Insurance for your Assurance

Personal Lines
Quotation Form

icon-braker
personal lines claim

    Consent to POPIA

    CONSENT TO PROCESS PERSONAL INFORMATION IN TERMS OF THE PROTECTION OF PERSONAL
    INFORMATION ACT, NO. 4 OF 2013 (POPIA)

    The Protection of Personal Information Act 4 of 2013 (“POPIA”) is South Africa’s Data protection law. It was created to give effect to the Constitutional right to privacy and protect the use of private information.

    We will be collecting your personal information to enable us to fulfil the mandate that we have been given by you.

    I,a natural person (Data Subject)
    with ID No:
    hereby give my consent to ProVérte Risk Management (Pty) Ltd (The Responsible Party) to collect, process and where legally required, distribute my personal information in accordance with the provisions of POPIA.

    1. I understand my right to privacy and the right to have my personal information processed in accordance with the conditions for the lawful processing of personal information.
    2. I understand the purposes for which my personal information is required and what it will be used for.
    3. I consent to third parties accessing the relevant information where necessary to perform their functions in relation to the services provided by ProVérte.
    4. I understand that ProVérte shares relevant and valuable information in the form of newsletters and updates to their clients, and consent is provided to add my email to their distribution database once I become a client.
    5. I understand my rights to request correction of personal information or object to the processing thereof in accordance with POPIA.
    6. I understand that should I refuse to provide the required consent and/or information ProVérte will not be able to do their job properly, the insurer’s may not be able to provide cover and I may not receive important and valuable information they share through newsletters.

    This consent will remain effective until such consent is withdrawn.

    Signed at
    this
    day of
    20
    Full Name of Data Subject
    Download the POPIA Compliance Policy: Download
    I have read and consent to the POPIA Compliance Policy and I have signed the consent form.
    To enable the insurers to underwrite risk fairly and to combat insurance fraud, we need to have your consent to verify and share policy information with insurers and other institutions as well as to access credit information held by other institutions. Do you give consent?
    Thank you for your response.

    Please note that without your consent the insurers will not be able to prepare a quotation.

    We use cookies to improve your experience on our website. By continuing to browse, you agree to our use of cookies
    X