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The next set of questions needs to be answered accurately and failure to provide this information now and during the life of the policy may result in the cancellation of your insurance.

Fields marked with an asterisk (*) are mandatory.

Help with promotion codes - this will open in a new window Where you see this symbol, you must read the information to ensure that you choose cover that suits your needs.

Your annual cover will start from the day you buy your policy.
 
 
 
 
 
 
 

Number of Adults

Please tell us how many adults in each age group* will be covered by this policy. You will need to buy one policy for each person over the age of 65. Help with number of adults - this will open in a new window
 
 
 
 
 
 
 
 
 

Number of Children

Please tell us how many children in each age group will be covered by this policy. Help with number of children - this will open in a new window
 
 
 
 
 

 
 
Are you an AA member?
 
 

 
 

Please check your details before proceeding.