Get an Instant Quote (2024)

Simply fill out the short, no-obligations form below to instantly see how affordable Gapwise cover can be.

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Personal & Contact Details*

Your premium will be displayed instantly - you won't have to wait for an email or phone call.

First Name*

Surname*

Cell Number*

Email*

Contact Preference*

Even though you selected "Email" as your preferred contact method, we may still contact you by phone if necessary (it's urgent and/or time-sensitive). If time allows, we will nevertheless attempt to contact you by email first.

Time to Contact*

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Cover & Plan

Cover & Plan Details*

Here you can select your level of cover and the plan you wish to receive a quote on.

Single or Family?*

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Dependants

Number of Dependants per Age Group*

You may add only dependants that are on your medical aid scheme.
If you have no dependants in an age group, simply leave the field blank.
Ensure that the respective age group selections are correct for the month when you would want cover to start (this month, next month or the month after next).
NOTE: Dependants only - the Principal Insured should not be counted here.

0 to 18

Dependants 0 to 18