Short Term Income Protection

If you have received a letter from us informing you that the insurer of your existing Income Protection policy is withdrawing from the market, you can use this form to confirm that you would like to accept the quotation for alternative cover.

To accept the quotation for cover you have received from us, please complete the form below. You will need your policy reference number which can be found in the letter we sent you.

Policy Reference Number(Required)

This will be be a series of letters and numbers separated by a forward slash e.g. ABCD/123456

Name

First name Surname

Declaration(Required)

If there is any information in the quotation you received that is missing or that is no longer accurate and requires updating, or you wish to provide different bank account details then please call us on 01904 476098 or email us at help@coverbaloo.co.uk.

By ticking this box you are confirming that the information shown in your quotation is up to date and accurate, and you confirm that you have read the quotation and policy details and you are happy to proceed. You agree that the bank account details we hold for you can be passed to the administrator of your new policy for the purposes of setting up a new direct debit instruction for your new cover.

Further information.

About our services

Read Policy Wording

Insurance Product Information Document

Need some help?

Email: help@coverbaloo.co.uk

Call: 01904 476098 (Mon-Fri, 9-5)

Short Term
Income Protection

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Short TermIncome Protection

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Short Term
Income Protection