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Have you smoked or used any tobacco-related products, including e-cigarettes or vaping, nicotine patches or gum, within the past 12 months?

Yes

No

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Monthly Budget

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Would you like to receive related information about Life Insurance, Mortgages and Protection, exclusive offers and competition details in the future by email?

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Are you happy to answer up to 3 quick medical questions to see if you qualify for a higher benefit amount?

Yes

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It is important to answer all questions truthfully and accurately otherwise a policy may not pay out in the event of a claim.

Are you currently waiting for a diagnosis, a hospital or specialist appointment or the results of any investigations for any medical condition?

Yes

No

In the last 12 months have you had, or been diagnosed with: a heart attack, stroke, cancer (or recurrence), or a terminal illness?

Yes

No

In the last five years have you had, or been diagnosed with, a heart attack, a stroke or cancer?

Yes

No