Lifecover Quote

Life Insurance – is a simple way to protect your family financially in the event of your death. If you die during the term of the policy or suffer from terminal illness then the policy will pay out a lump sum to your beneficiaries.

Critical Illness Cover – pays out a tax free lump sum of money upon diagnosis of a specified critical illness. Unlike life cover, Critical Illness Insurance pays out to yourself.

Income Protection – this provides a monthly tax free income until your selected retirement age, and will pay if you are unable to work due to injury, disability or during a long-term illness. This cover does not protect against unemployment.

To get a free quote, please fill in the short enquiry form below, OR SAVE TIME by completing a full application, and a member of our team of insurance brokers will provide you with a free quote without having to contact you first. Our simple and easy systems have helped thousands of people save money and get the cover that suited their individual needs.

Short Form

Tick Checkbox for Joint Policy

Title

First Name *

Surname *

Date of Birth

Do you smoke ?

yes

Phone *

Best time to call

9 - 12 a.m.

12 - 5 p.m.

5 - 9 p.m.

E-mail *

Joint Applicant Details
Title
First Name *
Surname *
Date of Birth
Do you smoke ?	yes	no

Type of Cover
Do you know the type of cover you require? yes	no
I would like an advisor to call me to discuss the types of cover available for my / our individual needs

Income Protection (if applicable)
Monthly benefit required (£)
Deferred Period (weeks)		(Normally covers length of time sick pay is received from employer.)
Annual Income (£)
Occupation

Life Cover or Critical Illness Cover (if applicable)
Amount of cover required (£)	(£20,000 - £1,500,000)
Type of cover
Period of cover (years)	(1 - 50)

Comments

Please tick this box if you are a Broker / Solicitor / Introducer

Full Name *
Tel. No.
E-mail