Critical Illness Insurance Enquiry Form Tell us your Critical Illness Insurance Policy requirementsCover Type*Select From The Options BelowCritical Illness CoverCritical Illness & Life Insurance PolicyCover Amount £* Cover Term* What Type Of Insurance Are You Looking For?*Select From The Options BelowLevel Term InsuranceDecreasing Term InsuranceLevel term insurance - If you die, this pays out a fixed amount of cash Decreasing term insurance - The payout will decrease roughly in line with your mortgage Employment Status*Select From The Options BelowEmployedSelf EmployedRetiredUnemployedTax CreditDisabled / CarerAre You a Smoker?* About YouName* First Last Telephone Number* Alternative Number* Email Address* Date Of Birth* Address* Street Address Address Line 2 City Post Code View the Privacy NoticeNameThis field is for validation purposes and should be left unchanged.
