Date of Birth Applicant 1

Date of Birth Applicant 2

Your Occupation

Additional information for a more accurate quote (optional)

Or cms


Weight : st/lbs
Or kgs

Waist Measure

Waist: inches or cms

Policy Requirement

Quotation based on

Selecting Benefit, quotes for premium/cost. Premium based quotes for maximum benefit for the premium.

Benefit amount Annual(max 55% of income)
Premium - if based on premium
[If benefit is greater than policy max, premium will reduce accordingly]
Benefit frequency
[to receive monthly or annual payments]
Policy Term: choose years or to age
Retirement age
Annual income including dividend
Annual dividend
Deferred period in months
Benefit period

Policy Options

Benefit escalation
Cover to remain static or increase annually with retail price index.
Policy features
Premium type
Employment type
Policy Commencement (Optional)