Brokers Lounge

Please click on the appropriate form to download. Please note that all forms are in PDF format and require a PDF Reader.

Origen-Bryte Claim forms:

• Bryte Liability Claim Form
• Bryte Goods in Transit Claim Form
• Bryte Property, Loss, Damage Claim Form
• Bryte Motor Accident Claim Form
• Bryte Motor Theft Claim Form
• Bryte Non-motor Claims under R20,000 Claim Form

Origen-OMI Claim forms:

• Old Mutual Glass Claim Form
• Old Mutual Motor Accident Claim Form
• Old Mutual Motor Theft Claim Form
• Old Mutual Property, Loss, Damage Claim Form
• Old Mutual Public Liability Accident Report Form

Underwriting Forms

• Debit Order PASA requirements
  Debit Order Authority Form
  Inceptions process is Signed Origen Quote and fully completed Debit Order Authority form – Proposal form is for the additional information to note on the policy.
• Bryte Personal Proposal Form
• Old Mutual Personal Proposal Form
• Bryte & Old Mutual Origen Commercial Proposal Form
• HCV Transporter Proposal Form
• No Claims Declaration – Bryte & Old Mutual
• Takaful Personal Proposal Form
• Takaful Commercial Proposal Form
• No Claims Declaration – Takaful