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FAMILY BENEFIT Plan
Get your instant certificate. Simply fill out the form and buy the plan.
✓Cover Details ✓Personal Information ✓Beneficiary Details ✓Identity Details ✓Preview Kindly fill in your Cover Details Sum Assured Premium Amount Select Premium Amount₦7,500₦10,000 Premium Frequency Cover Duration (in years) Escalation Rate Select Escalation Rate0%5%7.5%10% Live Cover Critical Illness Cover Permanent Disability Cover Interest Rate Kindly fill in your Family Information Gender Male Female First Name Surname Other Name(optional) Date of Birth Sum Assured Relationship Select RelationshipSpouseFatherMotherFather-In-LawMother-In-Law Remove Family Add Another Family Kindly fill in your Personal Information Gender Male Female First Name Last Name Other Name (optional) Phone Number Email Address Date of Birth National Identification Number State City Address Kindly fill in beneficiary Information Relationship Date of Birth First Name Surname Share Percentage (0-100) Beneficiary is a minor Guardian First Name Guardian Surname Guardian Phone Number Guardian Email Address Guardian Date of Birth Guardian Relationship Remove beneficiary Add a beneficiary Kindly fill in Identity Information Upload Signature Signature (3MB Max) Upload Photo Passport Photograph (3MB Max) Upload Identity Driver's license, National ID, or International Passport (3MB Max) Account Details Bank Name Account Number Account Name Medical QuestionsPersonal Contact InformationFirst NameLast NameOther NamesEmail AddressDate of BirthGenderMobile NumberNational Identification NumberStateCityAddress Back Get Quote I, hereby consent to the collection, processing, use and the transfer of personal data to third parties (within or outside Nigeria), for the purpose of assessing whether or not I will purchase an insurance cover or for the performance of any future insurance contract and any other data processing activities which may arise therefrom between myself and Leadway Assurance Company Limited (Leadway). I affirm that I am aware and take cognizance of my rights under the relevant Data Protection Laws in Nigeria and other terms detailed in the Data Privacy Policy of Leadway available on https://www.leadway.com/privacy-policy/. I authorize and consent that any person who may be in possession of, or hereafter acquire, any information pertaining to my records may disclose such information to Leadway.
Cover Details
Personal Information
Beneficiary Details
Identity Details
Preview
Beneficiary is a minor
First Name
Last Name
Other Names
Email Address
Date of Birth
Gender
Mobile Number
National Identification Number
State
City
Address
I, hereby consent to the collection, processing, use and the transfer of personal data to third parties (within or outside Nigeria), for the purpose of assessing whether or not I will purchase an insurance cover or for the performance of any future insurance contract and any other data processing activities which may arise therefrom between myself and Leadway Assurance Company Limited (Leadway). I affirm that I am aware and take cognizance of my rights under the relevant Data Protection Laws in Nigeria and other terms detailed in the Data Privacy Policy of Leadway available on https://www.leadway.com/privacy-policy/. I authorize and consent that any person who may be in possession of, or hereafter acquire, any information pertaining to my records may disclose such information to Leadway.