First Name

Last Name

Date of birth *

Your Title Mr Mrs Miss Ms

Is your biological sex either Male Female Intersex

Address line 1

Postcode

Telephone Number

Do you want to add a second applicant? No Yes

How much cover do you need?

How long do you need your policy to last?
This is the number of years you will be protected by the policy.

What type of cover do you need?
Level term policies pay out a fixed amount no matter when you claim during the policy term.
Decreasing term policies reduce the amount that's paid out over time. They are typically taken out to cover a repayment mortgage. Level term Decreasing term

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About you and your lifestyle

Please tell us some things about yourself:

How tall are you?

How much do you weigh?

What is your job?

Are you a smoker?
You are classed as a smoker if you have smoked or used any tobacco related products (including nicotine patches or e-cigarettes) within the last 12 months. Yes No

What is your average daily consumption of cigarettes over the last year?

What is your average daily consumption of cigars over the last year?

What is your average daily consumption of other tobacco (in grams) over the last year?

Which of these bests apply to you? I have never smoked I used to smoke but stopped over a year ago I've smoked in the last year but not every day I've vaped or used e-cigarettes in the last year I've used other nicotine replacement products in the last year

Please tell us some general things about your lifestyle:

How many pints of beer, lager or cider do you drink per week?

How many glasses of wine do you drink per week?

How many measures of spirits do you drink per week?

How many other alcoholic drinks do you drink per week?

Have any of these applied to you? I've been advised by a medical professional to cut down or stop drinking alcohol I've been referred for alcohol or drug specialist support such as Alcoholics or Narcotics Anonymous I've used recreational drugs in the last 10 years No

Are you involved in any of these? Armed forces (including reserves) Scuba diving Private flying, gliding or parachuting Motor car or motorcycle sport Mountaineering or rock climbing Sailing at sea or powerboat racing No

Have any of these applied to you? I've been banned from driving or convicted of dangerous or careless driving in the last 5 years I ride a motorbike, scooter or moped on the road No

Have you lived, worked or travelled outside the UK or European Union in the last 5 years, or do you have any plans to do so in the next year?
You don't need to tell us about:

- Business trips of less than a week
- Holidays less than 30 days

Yes No

Do you have existing Life insurance or are you applying for any other Life insurance?* Yes No

Do you have existing Critical Illness insurance or are you applying for any other Critical Illness insurance? Yes No

Additional Lifestyle Questions

Occupation:

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Could your loved ones survive financially if you passed away?

October 2019

Could your loved ones survive financially if you passed away?

No I could not. Quote me Now Im not sure, tell me more

For most people, that is a simple question and as such provisions need to be made. Either a large savings account that is guaranteed to supplement the loss of household income, or be-friend a mate or family member to give you some cash.

But unfortunately we often need something more concrete, something that doesn’t take too much away from your month to month living but provides an awful lot in the event of a disaster. That gives you extra sleep every morning, knowing your family are protected. This could be the reason for the sharp increase in Brits taking out life insurance.

A life assurance policy allows you to make sure that your family is protected in the event that you are no longer able to provide for them. How would your family cover..

> Day-to-day living costs?

>Mortgage repayments?

>Household bills?

There are many different types of life insurance that may be suitable to your needs, including:

Mortgage Life Insurance
Critical Illness Insurance
Waiver of premium
Family Income benefit
Whole of life insurance
Over 50 life insurance

However, in the UK, only 1 in 10 people in employment currently have a protection insurance policy in place.

There are a number of theories as to why that figure could be so low, one of which could be most of those people don’t have dependants or responsibilities…

Quote me for Life cover

What does the General Public believe

Trust for insurers continues to be a major factor in preventing people from purchasing insurance products.

Not only do people not trust insurers to sell them the right products, but they also don’t believe that they will pay out.

The UK public has a very low expectation of how many life policies are actually paid out and how much money goes to the loved ones of those that were lost.

Latest figures from the ABI show that insurers paid out almost £14m per day in personal protection policies in 2017, a £340 million increase year-on-year.

What’s more, nearly 98% of claims were paid, while the number of payouts increased by more than 20,000 compared to 2016.

If you are one of those people who doesn’t mind going into a public speech with notes, or if you don’t follow the colours at the traffic lights, then you may not like to protect yourself. But, protecting your loved ones is a different situation.

You can align the protection cover with your families financial liabilities:

Mortgage Life Insurance

Mortgage protection is life insurance for mortgage purposes, designed to pay off your mortgage if you die or if you are diagnosed with a terminal (or critical) illness during the term of your policy. It provides a financial safety net for your loved ones, ensuring they are not left to struggle to meet mortgage payments at such an emotional time.

You can select one of two mortgage protection insurance plans: ‘level term’ and ‘decreasing term’. Level term assurance is designed so that the cover will remain the same throughout the full term of the policy. This will ensure that your mortgage will be paid off in the event of death and possibly create a surplus for your loved ones if you have a repayment mortgage.

The other option, Decreasing term assurance, is designed to repay a typical repayment mortgage in the event of death or diagnosis of a terminal (or critical) illness. This cover simply reduces each year in line with your mortgage. The premiums are generally lower to reflect the reduction in cover as the mortgage is repaid. Ideally you should have sufficient cover for both your mortgage and your family’s other needs.

Critical Illness Cover

Would you be able to support yourself financially if you were unable to work due to suffering a critical illness, such as a heart attack, stroke or even cancer? Could you maintain your mortgage repayments and other household bills? Could you afford any necessary home adaptions?

The most comprehensive critical illness cover policy will cover all of these things. To Summarise, Could you live without any money should the worst happen?

Critical illness cover pays out if you are diagnosed with a specified critical illness (e.g. heart attack, stroke or cancer) and will also pay out if you are diagnosed with a total and permanent disability.

It can run be held alongside a life assurance policy or as a stand-alone product and is absolutely crucial, whether you are single or you have a family to look after. Having the financial security of a critical illness policy means that you can take the time required to make a full recovery without the need to rush back to work allowing you to keep on top of your financial commitments and, more importantly, your health.

Some insurers will also include, an additional benefit of critical illness cover for your children, so should any of your children fall critically ill, the insurer will make a lump sum payment of up to £25,000 .(subject to the terms of your plan).

Waiver of Premium

If you were out of work, would you be able to afford your life insurance premiums? If not, you may be forced to cancel your life insurance policy leaving you without cover.

If your policy includes a waiver of premium, then there is no need to worry. If you are unable to work due to an accident or sickness for a period in excess of 26 weeks, your insurer will pay your premiums for you and will continue to do so until you have returned to work, become incapacitated or pass away. This eliminates the worry of becoming uninsured if you can’t afford your premiums.

Note: (Waiver of Premium is a product that you can add on to your life assurance policy, usually for a small extra cost).

Family Income Benefit

This is another form of life insurance which, instead of paying out a lump sum of money following your death, pays out monthly tax-free amounts from the time you die to the end of the policy. With this type of policy you will be providing a monthly income for your family, similar to what you are earning at present, long after you are gone.

Whole of Life Insurance

Is life insurance for life? With whole of life insurance, it is.

Whole of life insurance is guaranteed to last until the day you die, no matter what. Whether you want to leave some money behind to ensure that funeral costs are taken care of or just want to provide your loved ones with a guaranteed lump sum of money, whole of life insurance can do just that.