Request a quote for Income Protection Insurance

Obtain a Quote It's a simple process to obtain a quote for your life insurance requirements. Please complete the form shown below, please note contact section must be fully completed in order for a quote to be generated. Then input data into the relevant areas for which you would like quotes on. To minimise time on phone provide as much information as possible. Note: life insurance  can only be provided to permanent residents of Australia, or those people in the application process for permanent residency.
Quote Form Full Name Email: Contact Number: Date of Birth Gender: Choose...MaleFemale State: Choose...ACTNSWQLDSATASVICWA Occupation: Current Income (annual) *1: When did you last use tobacco or nicotine? Choose...NeverNone in the last 5 yearsNone in the last 4 yearsNone in the last 3 yearsNone in the last 2 yearsNone in the last 1 yearsCurrent Smoker Do you intend to fly as a Private Pilot? Yes   No Do you work in a hazardous occupation? Yes   No Within the last 5 years, have you been convicted of either reckless driving or driving while under the influence, received 3 or more moving violations or had your license suspended/revoked? Yes   No Do you engage in any risky activities such as racing, scuba diving Yes   No Comments Your comments What waiting periods would you like quotes on? 14 Days 1 month 2 months 3 months 6 months 12 months 24 months What benefit periods would you like quotes on? 2 years 5 years Age 60 Age 65	Notes The points below help submit the request form correctly: *1 -  Income Protection will pay the life insurance a monthly benefit equal to 75% of their income. This is paid after the waiting period is reaches and continues to the end of the benefit period if the person is unable to return to work due to sickness or injury)
Privacy: Please note you are required to submit personal details in order to obtain a quote. We operate under the National Privacy Principles, your information is used only for the purpose of generating quotes. Please submit genuine names and contact details otherwise quotes will not be produced.