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Personal Accident Insurance (with optional Sickness cover)

Application Form

Apply now for your Protect My Income (PMI) Personal Accident Insurance

(with optional Sickness cover). It’s simple and will only take a few minutes of your time.

Just checking……

Before we continue with the application, we need to confirm the following.

• You are 18 or over

• You are under the age of 61

• You live in the UK

• You are employed or self employed

• You work a minimum of 16 hours per week

If you don’t meet these criteria, we can still help you. Call us on 0333 355 2468 between 9am and 5pm Monday to Friday to speak to one of our friendly advisors.

Let’s get started on your application

The application process is straight forward and it helps if you have the following information to hand.

• Personal details

• Employment details

• Bank details

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