Use our online life insurance application form for a free discounted quote for a great life insurance policy

Life insurance application form

For all you need to know about life insurance we have put together a comprehensive life insurance guide below.

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One simple online application for life-insurance and we will find you the best life insurance available to you and discount it further still.

If you would like more information about life insurance CLICK HERE

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Life Insurance Application

Use our quick online application form to apply for a discounted life insurance policy from leading insurance companies. WE will find the best life insurance cover for the best premium, and discount it further.

 All fields must be completed for us to give you a valid Life Insurance quote
 Life Cover For A Fixed Term - To receive a lump sum death benefit 
 Life Insurance Only (includes Terminal Illness Cover at no extra cost)
Critical Illness Cover Only
One Policy Covering Both Life Insurance & Critical Illness Cover
 If you select 'One Policy Covering Both Life Insurance & Critical Illness Cover' please note that this will give joint Life/Critical Illness cover on a 'first event' basis. i.e. Life cover will NOT continue after payment for Critical Illness. If continuing cover is required then two separate policies must be purchased.
 How much to you want to be insured for? £ 
 How many years do you want to be insured for? 
 Do you need the insurance to insure your repayment mortgage in the event of your death?
 Do you need the insurance to pay a lump sun to your family in the event of your death?
 Do you require Guaranteed or Reviewable premiums? 
  First Person Covered
 Name 
 Date Of Birth   dd/mm/yyyy 
 Gender 
 Email 
 Daytime Phone 
 Evening Phone 
 Preferred Call Time 
 Address 
   
 Town 
 County 
 Post Code 
 Has this person smoked any tobacco products in the last 12 months? 
  Second Person Covered
 Name
 Date Of Birth   dd/mm/yyyy
 Gender
 Has this person smoked any tobacco products in the last 12 months?
  Submit Your Application
 Do you want us to quote you the cheapest monthly premium?YesNo
 We would like to keep you informed of any new product developments and offers with our quarterly newsletter. Would you like to receive a copy?YesNo
 You have read and understood our Initial Disclosure Document below?YesNo 
 
 
Life insurance from leading insurers and discounted further with our guarantee to beat cheaper quotes for the same policy.
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OUR TYPICAL, VARIABLE RATE IS 10.9% APR. RATES RANGE FROM 7.25% to 27.60% APR
The actual rate available will depend upon your circumstances. Ask for a personalised illustration.
THINK CAREFULLY BEFORE SECURING OTHER DEBTS AGAINST YOUR HOME.
YOUR HOME MAY BE REPOSSESSED IF YOU DO NOT KEEP UP REPAYMENTS ON YOUR MORTGAGE OR ANY OTHER DEBT SECURED ON IT.
Special plans on different terms for clients with CCJ's arrears, and for the self employed without income proof. (fees may apply but only on problem cases - max 10% - no loan, no fee)
All loans subject to status in the UK to home owners aged 18 and over and may be secured on property.
Written quotations available on request. Other terms and amounts available

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