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Income Protection Insurance Quick Quote

Income Protection is available to people aged 18 - 55 and is subject to eligibility. Your application may be affected by your occupation, health, smoker status and other aspects of your lifestyle. Terms and conditions apply.

For more information, please contact your Financial Adviser or contact or complete the form below. This information is to enable us answer your enquiry and provide you with a quotation as quickly as possible (* denotes required fields).

. Not sure of what to select? Click on the symbol for help.

Client Details

Please enter your First name:


Please enter your Last name:


What is your Date of Birth?:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Please enter your email address:


Please enter your phone number:


Gender: * (Choose smoker if you've used tobacco/nicotine products in the last year)
Male (Non-Smoker) Female (Non-Smoker) Male (Smoker) Female (Smoker)

Agent Code:


Promotion Code:

Cover Details

Should your cover protect you against redundancy and unemployment?:
Yes      No

Q1. How soon would you like your cover to start paying?
After 4 weeks incapacity After 8 weeks incapacity After 13 weeks incapacity After 26 weeks incapacity After 52 weeks incapacity

What is your annual salary before tax? (€)


Until what age would you like you cover to run to?:
Please Select
50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65

What is your occupation?


Would you like your benefit to increase with inflation? :
Yes      No

To avoid automatic emailers please answer the following question:
What is 40 + 20? *

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