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1.
Group
Quote
Quote Details
Please note this quote form is for information purposes only, intended to provide a non-binding indication of premium for groups of 3-50 employees. If you have any questions, would like a binding quote or have a larger group quote, please contact our underwriting team on
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or please see our contact details
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.
Currency
British Pound
Euro
US Dollar
Area of cover
Please select
Area 1 - Europe, Middle East, Africa, Asia and Oceania; excluding China, Hong Kong and Singapore.
Area 2 - Worldwide excluding the USA.
Area 3 - Worldwide.
Level of cover
Please select
Select
Primary Plus
Primary
Excess
Please select Level of Cover
Area of Cover
Please select
Europe
Worldwide
Plan
Please select
Basic
Standard
Comprehensive
Basic
Standard
Comprehensive
Lump Sum Disability pays (up to) 10 times your Gross Annual Salary when you are permanently disabled from attending your normal occupation due to an accident or illness.
Average Annual Salary
Occupation Class
Please select
Admin or clerical duties only
Skilled or semi-skilled work/no hazardous conditions
Manual labour / heavy machinery / exposure to hazard
Sum Insured
Please Select
1 x Salary
2 x Salary
3 x Salary
4 x Salary
5 x Salary
6 x Salary
7 x Salary
8 x Salary
9 x Salary
10 x Salary
Optional Temporary Disability Benefit
Sum Insured
Not Required
25% Salary
50% Salary
75% Salary
Deferred/Excess
30 days
60 days
90 days
180 days
Sum Insured: Fixed or Average per person
Please Select
£50,000
£100,000
£150,000
£250,000
£500,000
£750,000
£1,000,000
£1,500,000
£2,000,000
£2,500,000
£3,000,000
£5,000,000
£6,500,000
Employees
Age
Number
0-18
19-25
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65
66-70
Total
Your Details
*Indicated required fields
Name*
Email*
Phone
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+355 (Albania)
+213 (Algeria)
+376 (Andorra)
+244 (Angola)
+672 (Antarctica)
+54 (Argentina)
+374 (Armenia)
+297 (Aruba)
+61 (Australia)
+43 (Austria)
+994 (Azerbaijan)
+973 (Bahrain)
+880 (Bangladesh)
+375 (Belarus)
+32 (Belgium)
+501 (Belize)
+229 (Benin)
+975 (Bhutan)
+591 (Bolivia)
+387 (Bosnia and Herzegovina)
+267 (Botswana)
+55 (Brazil)
+673 (Brunei Darussalam)
+359 (Bulgaria)
+226 (Burkina Faso)
+257 (Burundi)
+855 (Cambodia)
+237 (Cameroon)
+238 (Cape Verde)
+236 (Central African Republic)
+235 (Chad)
+56 (Chile)
+86 (China)
+57 (Colombia)
+269 (Comoros)
+243 (Congo)
+242 (Congo (Brazzaville))
+682 (Cook Islands)
+506 (Costa Rica)
+225 (Cote d'Ivoire)
+385 (Croatia)
+53 (Cuba)
+357 (Cyprus)
+420 (Czech Republic)
+45 (Denmark)
+253 (Djibouti)
+593 (Ecuador)
+20 (Egypt)
+503 (El Salvador)
+240 (Equatorial Guinea)
+291 (Eritrea)
+372 (Estonia)
+251 (Ethiopia)
+500 (Falkland Islands (Malvinas) )
+298 (Faroe Islands)
+679 (Fiji)
+358 (Finland)
+33 (France)
+594 (French Guiana)
+689 (French Polynesia)
+241 (Gabon)
+220 (Gambia)
+995 (Georgia)
+49 (Germany)
+233 (Ghana)
+350 (Gibraltar)
+30 (Greece)
+299 (Greenland)
+590 (Guadeloupe)
+502 (Guatemala)
+224 (Guinea)
+245 (Guinea-Bissau)
+592 (Guyana)
+509 (Haiti)
+379 (Holy See (Vatican City State))
+504 (Honduras)
+852 (Hong Kong)
+36 (Hungary)
+354 (Iceland)
+91 (India)
+62 (Indonesia)
+98 (Iran)
+964 (Iraq)
+353 (Ireland)
+972 (Israel)
+39 (Italy)
+81 (Japan)
+962 (Jordan)
+254 (Kenya)
+686 (Kiribati)
+850 (Korea (North))
+82 (Korea (South))
+965 (Kuwait)
+996 (Kyrgyzstan)
+856 (Lao PDR)
+371 (Latvia)
+961 (Lebanon)
+266 (Lesotho)
+231 (Liberia)
+218 (Libya)
+423 (Liechtenstein)
+370 (Lithuania)
+352 (Luxembourg)
+853 (Macao)
+389 (Macedonia)
+261 (Madagascar)
+265 (Malawi)
+60 (Malaysia)
+960 (Maldives)
+223 (Mali)
+356 (Malta)
+692 (Marshall Islands)
+596 (Martinique)
+222 (Mauritania)
+230 (Mauritius)
+52 (Mexico)
+691 (Micronesia)
+373 (Moldova)
+377 (Monaco)
+976 (Mongolia)
+382 (Montenegro)
+212 (Morocco)
+258 (Mozambique)
+95 (Myanmar)
+264 (Namibia)
+674 (Nauru)
+977 (Nepal)
+31 (Netherlands)
+599 (Netherlands Antilles)
+687 (New Caledonia)
+64 (New Zealand)
+505 (Nicaragua)
+227 (Niger)
+234 (Nigeria)
+683 (Niue)
+672 (Norfolk Island)
+47 (Norway)
+968 (Oman)
+92 (Pakistan)
+680 (Palau)
+970 (Palestinian Territory)
+507 (Panama)
+675 (Papua New Guinea)
+595 (Paraguay)
+51 (Peru)
+63 (Philippines)
+870 (Pitcairn)
+48 (Poland)
+351 (Portugal)
+974 (Qatar)
+262 (Réunion)
+40 (Romania)
+7 (Russian Federation)
+250 (Rwanda)
+290 (Saint Helena)
+508 (Saint Pierre and Miquelon)
+685 (Samoa)
+378 (San Marino)
+239 (Sao Tome and Principe)
+966 (Saudi Arabia)
+221 (Senegal)
+381 (Serbia)
+248 (Seychelles)
+232 (Sierra Leone)
+65 (Singapore)
+421 (Slovakia)
+386 (Slovenia)
+677 (Solomon Islands)
+252 (Somalia)
+27 (South Africa)
+211 (South Sudan)
+34 (Spain)
+94 (Sri Lanka)
+249 (Sudan)
+597 (Suriname)
+268 (Swaziland)
+46 (Sweden)
+41 (Switzerland)
+963 (Syrian Arab Republic (Syria))
+886 (Taiwan)
+992 (Tajikistan)
+255 (Tanzania)
+66 (Thailand)
+670 (Timor-Leste)
+228 (Togo)
+690 (Tokelau)
+676 (Tonga)
+216 (Tunisia)
+90 (Turkey)
+993 (Turkmenistan)
+688 (Tuvalu)
+256 (Uganda)
+380 (Ukraine)
+971 (United Arab Emirates)
+44 (United Kingdom)
+1 (United States of America)
+598 (Uruguay)
+246 (US Minor Outlying Islands)
+998 (Uzbekistan)
+678 (Vanuatu)
+58 (Venezuela (Bolivarian Republic))
+84 (Viet Nam)
+681 (Wallis and Futuna Islands )
+967 (Yemen)
+260 (Zambia)
+263 (Zimbabwe)
Company Name
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2.
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Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic)
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
East Timor
Ecuador
Egypt
El salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City State)
Honduras
Hong Kong
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Iceland
India
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Iran
Iraq
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Jamaica
Japan
Jordan
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Mongolia
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Morocco
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Myanmar
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Nauru
Nepal
Netherlands
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New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
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Peru
Philippines
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Poland
Portugal
Puerto Rico
Qatar
Republic of Guinea
Reunion
Romania
Rwanda
Saint Helena
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Saint Pierre and Miquelon
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Samoa
San Marino
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Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
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Venezuela
Vietnam
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