54336
 
Register Here
Personal Details
Title (*)
First Names (*)
Last Name (*)
Date of Birth
Contact Details
Postcode
Building Name/No & Street
Address 2
Address 3
Address 4
Main Phone
Email Address (*)
Please read and acknowledge the terms and conditions for the policy;
•  You must be a permanent resident in the United Kingdom and been resident here for at least 6 out of the last 12 months
•  You must be registered with a GP in the United Kingdom
•  You must be in the UK at the time of purchasing this policy.
•  You must not be more than 80 years of age when purchasing the policy.
•  You will not be covered for any Pre-existing medical conditions as defined in the ‘Important conditions relating to health’ section of your policy wording.
•  Your group falls into one of the below categories;
      •  Individual – 1 person aged 17 or over
      •  Couple – You and Your partner aged 17 or over and living together at the same address
      •  Family – You and Your partner aged 17 or over and living together at the same address, plus a maximum of 6 of Your children/ grandchildren aged under 17
      •  Group – A minimum of 2 Individuals and up to a maximum of 6 individuals
I agree with the terms and conditions above
(*) - required field
 
Please note we do not provide cover for people aged over 75 or under 16.