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Short Term
Income Protection

Confirm your details to accept your quotation

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