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STEP 1: Contact Details



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STEP 2: Personal details

Personal Information
Date of Birth
Address










Contact Details
Marketing Consent


Monthly Premium: R 0.00
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STEP 3: Premium payer

Monthly Premium: R 190.00
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STEP 4: Debit Order Details

I hereby authorise Legal Expenses Insurance Southern Africa Limited (trading as LegalWise and herein referred to as LegalWise) to arrange a monthly premium deduction(s) and or deduction(s) of arrear(s) by means of a Debit Order from my nominated bank account. I acknowledge that all payment instructions issued by LegalWise shall be treated by my above mentioned bank as if the instruction has been issued by me personally. I may not delegate obligations in terms of this authority to a third party without prior written consent from LegalWise. I acknowledge that LegalWise may not cede or assign any of its rights to a third party without my written consent. If the deduction is unsuccessful to meet the obligation, LegalWise is entitled to track my account with Naedo or a similar system and re-present the instruction for payment monthly on alternative dates when the obligation in terms of the agreement is due. This authority will continue until cancelled by me by giving LegalWise thirty days written notice.

By clicking Next, I agree to the terms above.


Monthly Premium: R 190.00
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STEP 5: Employer Details



Monthly Premium: R 190.00
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STEP 6: Nominated Spouse/Life Partner Details

Monthly Premium: R 190.00
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STEP 7: Nominated Beneficiary Details


Monthly Premium: R 190.00
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STEP 8: Optional Benefits

In addition to our Gold, GoldPLUS or Platinum Membership options, we offer the LegalWise Profession Specific Legal Plans - designed exclusively to protect, guide and support health care professionals, police, teachers, enforcement officer and members of the defence force.
Read more




Monthly Premium: R 190.00
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STEP 9: Main Member's Authorisation

I confirm that all the details provided are correct and by submitting this form I acknowledge that I am applying for Membership. I have read the Statutory Notice attached hereto and understand it. Further, I consent to my information being used for the purposes related to the services provided by Legal Expenses Insurance Southern Africa Limited. I also confirm that no financial advice was provided to me nor was needs analysis conducted for me by the Independent Contractor acting on behalf of Legal Expenses Insurance Southern Africa Limited.

By submitting this form I agree to the terms above.

Monthly Premium: R 190.00
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