Add A Pet to your Pet Insurance Plan

First Name*

Surname*

Email*

We will send your policy documents to this address

New Pet Name*

Pets Date of Birth*

DD slash MM slash YYYY

If your pet is younger than 6 weeks old, please wait for them to grow a little before coming back to add them to your cover. All dogs between the ages of 8 & 9 & cats 9 years & over are subject to a complete vet history when joining Ultimate360 or Essential. All dogs over 9 years of age are offered Lite or Accident plans which have no age maximums, not Ultimate360 or Essential.

Cat or Dog*

Dog

Cat

Breed of Dog*

Breed of Cat*

Gender*

Male

Female

Is your pet sterilised? (Optional)

Yes

Policy No:*

This is your existing policy number for your current policy with MediPet.

Coupon Code

Cover option for your pet*

Accident

Lite

Essential

Ultimate360

Cover option for your pet*

Accident

Lite

Do you also want cover for a pre-existing condition?*

Yes

Lite: Limited, affordable accident & illness cover for all ages. Pre-existing condition cover can be added for an additional premium. (Up to 4 claims a year, maximum R13 760 per claim, with the annual maximum of R40 000).
Essential: Worry-free comprehensive cover for accidents, illness & holistic wellness, within annual maximum of R60 000.
Ultimate360 : Worry-free, comprehensive cover for accidents, illness, holistic wellness, & additional benefits like dental care for complete peace-of-mind, within annual maximum of R72 000.
Accident: Basic, unforeseen accident cover, without waiting periods, within R25 000 annual maximum.

Accident: Basic, unforeseen accident cover, without waiting periods, within R25 000 annual maximum.
Lite: Limited, affordable accident & illness cover for all ages. Pre-exiting condition cover can be added for an additional premium. (Up to 4 claims a year, maximum R13 760 per claim, with the annual maximum of R40 000).

Routine Care Add-Ons

Routine Lean for R65 per month, R1 100 per year (R320 Savings)

Routine In-Between for R130 per month, R2 200 per year (R640 Savings)

Routine Supreme for R195 per month, R3 300 per year (R960 Savings)

Premium Saver

Premium Saver 1 000
R1 000 flat excess on all Lite, Day-2-Day, Hospital & Dental claims, for 7.5% discount on premium

Premium Saver 2 000
R2 000 flat excess on all Lite, Day-2-Day, Hospital & Dental claims, for 15% discount on premium

Has your pet been adopted or rescued within the last 6 months?*

Yes

If your pet was rescued in the last 6 months, & is over the age of 18 months upon joining, & no vet history is available, your pet will have a maximum of R3 000 towards illnesses for the first 6 months. (Claims due to an accident will not have this temporary limit applied).

Forgotten to add routine care?

This add-on contributes up to R3 300 per year towards preventative care including vaccinations, tick/flea & deworming, microchipping, sterilisation, grooming, nail-clipping, training & puppy socialisation classes.

Eye/Ear Conditions*

Yes

Add information regarding Eye/Ear Conditions

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