Transcription of Application to add dependants (with underwriting) …
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Application to add dependants (with underwriting) …
Page 1 of 10LA Health Medical Scheme, registration number 1145, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Discovery Health (Pty) Ltd is an authorised financial services detailsTel: 0860 103 933 PO Box 652509, Benmore 2010 to add dependants (with underwriting) Complete this form if you want to add dependant/s to your membership of LA Health Medical we areLA Health Medical Scheme (referred to as the Scheme ), registration number 1145 is the Scheme that your dependant/s are applying to become a member of. This is a non-profit organisation, registered with the Council for Medical Health (Pty) Ltd (referred to we us and our or as the administrator ) is a separate company and an authorised financial services provider ( registration number 1997/013480/07). We take care of the administration of your membership for the Scheme. Please follow these steps to help us process your Application : Please use one letter per block, complete with black ink and print clearly and remember to sign the form.
LA Health Medical Scheme, registration number 1145, is administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07. Discovery Health (Pty) Ltd is an authorised financial services provider.
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