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What type of protection would you like a quote for?
*
Income Protection
Life Insurance
Serious Illness Protection
Mortgage Protection
You can choose more than one option.
Do you currently have a life insurance policy in place?
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Yes
No
Is it a Section 72 Life Insurance policy?
*
Yes
No
I don't know
What type of business protection would you like a quote for?
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Executive Income Protection
Key Person Insurance
Partnership & Shareholder Insurance
You can choose more than one option.
Do you require cover for one or two people?
*
One Person
Two People
How much Life Insurance do you require?
*
This is the lump-sum to be paid out in the event of death.
How much Life Insurance do you require?
*
This is the lump-sum to be paid out in the event of death.
How much Mortgage Protection do you require?
*
This is your mortgage loan balance and is the lump-sum to be paid out in the event of death.
How much Serious Illness Protection do you require?
*
This is the lump-sum to be paid out in the event of a successful claim on the policy.
How many years would you like life cover for?
*
The maximum is a 40 year term and cover is available up to age 91.
What is your mortgage term?
*
This will determine the term of your Mortgage Protection.
How many years would you like serious illness cover for?
*
The maximum is a 40 year term and cover is available up to age 75.
What's your gross annual salary?
*
This will determine your maximum Income Protection amount.
What's your gross annual salary?
*
This will determine your maximum Executive Income Protection amount.
What deferral period would you like?
*
52 weeks (Cheapest)
26 weeks
13 weeks
8 weeks (Most expensive)
This is the time between the first day you can't work due to illness or injury, until the start of your claim.
Estimated retirement age
Selected Retirement Age:
55
This is the term of your Income Protection policy.
What's your occupation?
*
Do you smoke or use nicotine replacement products?
*
Yes
No
Is the second person a smoker or use nicotine replacement products?
*
Yes
No
Mortgage Type
*
First Time Buyer
Switcher / Remortgage / Equity Release
Second Time Buyer / Moving Home
Buy To Let
Is this for a single or joint mortgage?
*
Single
Joint
How many years are you with your current employer?
*
Less than a year
1 year
2 years
3 years
4 years
5+ years
What type is your business?
*
Sole Trader
Partnership
Limited Company
How many directors are there?
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1-5
5+
How many employees are there?
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1-5
5+
Do you have any group benefit schemes in place?
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Yes
No
Do you have any business owner protection in place?
*
Yes
No
e.g. Income Protection or Key Person Insurance
What year was the business founded?
*
Employment Sector
*
e.g. Business, Finance, Trade, Technology.
What's your date of birth?
*
What's the second person's date of birth?
*
What's your gross annual salary?
*
If you're not sure, an estimate will suffice.
What's the second applicants gross annual salary?
*
If you're not sure, an estimate will suffice.
Estimated Current Mortgage Balance
*
Estimated Mortgage Term Remaining
Years Remaining:
20
Do you currently have a pension?
*
Yes
No
Are you currently contributing to your pension?
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Yes
No
Have you ever had a pension in previous employment?
*
Yes
No
What's your name?
*
First
Last
What's your email address?
*
What's your phone number?
*
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