ADVICE

KEYFACTS

CONDITIONS
and
DISCLAIMERS

Life Assurance Online is a site designed to help you obtain a cheap quote for Life Insurance, Critical Illness Insurance, Income Protection Insurance and other insurance products. All requests and information you provide through this site will be dealt with by Face to Face Finance (Anglia) Ltd which is regulated by the Financial Services Authority and recorded in the Register under no 439288. They are able to research the whole UK life insurance market on your behalf.

This site is intended for UK residents and British expatriates only.

Business Life Insurance Quote Form

This quote form caters for level term life insurance for Keyman Life Insurance and Employee Death in Service benefits. It also caters for whole of life insurance for Keyman cover if required. Critical Illness Life Insurance is also available as an option on the quote. We kindly ask you to complete all fields highlighted in red to provide you with a quote.

Title

First Name

Surname

Date of Birth

Male/Female

Smoker

Occupation

Do you own a property in the UK? (British expats only).

Yes No

Address 1

Address 2

Town/City

County

Post Code

Telephone Number

When can we contact you on this telephone number?

Nationality

Country of Residence

Email Address

Employer's Name

Employer's Address

Employer's Postcode

Employer's Telephone No

Term of Years

years

Term of Assurance

Amount of Cover Required

Critical illness required?

Yes No

Premium Protection Required?

Yes
No What does this mean?

Priority response required?

Yes Not Urgent

If you require clarification on your options please tick

How did you find us?

If you selected 'Search Engine', please specify

Additional comments

As a further service, we would like to keep you informed by email of new developments and activities in the insurance and financial planning markets, possibly in the form of a newsletter. If you would like to receive further information please select Yes on the pop up menu.

Please click on SEND once or CLEAR to re-enter.

Please note that quotations are subject to underwriting and premiums cannot be guaranteed until confirmed by the assurance company.