Cover DetailsQuote Reference Serious Illness Cover*Minimum Serious Illness Cover is 10% of the Life Cover amount. Also, as any serious illness claim pay Out ,acts as an advance payment of the lifecover,it Cannot exceed the lifecover amount.Term of Policy*10111213141516171819202122232425262728293031323334353637383940Number of years that you require policyBasis of Cover*Single Cover - 1 Person - Single PayoutSingle Cover - Convertible - 1 Person - Single PayoutJoint Cover - 2 People - Single PayoutJoint Cover - Convertible - 2 People - Single PayoutDual Cover - 2 PeopleDual Cover - Convertible - 2 PeopleSingle Cover- One person to be covered Joint Cover- Two people coverage, with payout on first person to claim, per benefit.Frequency*MonthlyAnnualIndexation*YesNoYour DetailsName* First Last Contact Number*Email Address* Smoker Status*Non-SmokerSmokerDate of Birth* DD MM YYYY Sex*MaleFemaleSecond Person's DetailsSmoker Status*Non-SmokerSmokerDate of Birth* DD MM YYYY Sex*MaleFemaleT&C I have read and understand the terms and conditions and privacy policy