Individual Personal Accident Insurance Quote

/Individual Personal Accident Insurance Quote

Please complete the following form in full to receive a quotation.

Your Name (required)

Address (required)

Your Email (required)

Contact Phone (required)

Age (required)

Are you Federation of Window Cleaners Members?
 Yes No

Occupation (required)

Is window cleaning work undertaken? (required)
 Yes No

If Yes

Is this undertaken using water fed pole systems?
 Yes No

Is ladder work undertaken above 3 storeys in height?
 Yes No

Do you use ropes/platforms
 Yes No

Please detail any hazardous leisure activities:

Available cover levels

CoverPlatinumGoldSilver
Accidental Death£20,000£15,000£10,000
Permanent Total Disablement£20,000£15,000£10,000
Temporary Total Disablement£400 per week
2 week excess
Up to 104 weeks
£300 per week
2 week excess
Up to 104 weeks
£200 per week
2 week excess
Up to 104 weeks
Premiums Applicable from£190£150£100

Indicate the required cover level

Other Cover (please specify below)

Are you human?