The plan you are applying for is designed to meet the needs of people who are looking for a guaranteed acceptance life insurance plan to pay a cash sum upon death. If this plan meets your needs please continue with the application. The following questions must only be answered by the person to be insured and they must be resident in England, Wales, Scotland or Northern Ireland.

Why do you need this plan? This will help us give you relevant product information. (select all that apply)

We ask this question so we can understand why our customers are applying for this product and to allow us to present the most relevant information suited to their needs. Please tick all options that apply

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Your date of birthHelp - More info - Date of Birth

You must be between the ages of 50 and 80, a UK resident and have spent at least 183 days in the UK in the last tax year.

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• Don’t worry, we will not use it for marketing material without your permission.
• We will send you a copy of your quote.
• We need this should you decide that you want to apply.

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In the last 12 months have you used tobacco, e-cigarettes or nicotine replacement products?

'Yes, Regularly' means more than once a week.
'Yes, Occasionally' means once a week or less.

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Your Quoting Reference code may have been included in a letter from us about Over 50s Life Insurance

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The amount you can pay per month is dependent on your age and your smoker status. The minimum you can pay is £{{ lowerPPM }} per month and the maximum you can pay is £{{ upperPPM }} per month

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