Accidental permanent injury insurance application

Please select one of the cover options below

The amount we’ll pay out for a successful claim depends on the level of cover you choose (we may pay out more for more severe injuries too). Make sure you check the benefits of each cover to see which best fits your needs.

Cover levels and benefits

Cover section % of £ amount chosen payable
Section A – Permanent bodily injury.
Please note that the benefits stated for loss of use of arm/leg represent a full loss of use.
Amputation One arm/leg 100%
Two arms/legs 150%
Three arms/legs 200%
Four arms/legs 250%
Total loss of use One arm/leg 100%
Two arms/legs 150%
Three arms/legs 200%
Four arms/legs 250%
Other permanent injury 100%
Section B – Sensory disability Loss of sight One eye 100%
Loss of sight Both eyes 200%
Loss of hearing One ear 100%
Loss of hearing Both ears 200%

Single cover

Monthly premium Value of cover*

* Policy provides cover for yourself only

With partner cover

Monthly premium Value of cover**

** Policy covers both yourself and your partner. Value of cover is per insured person.

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