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I need an income protection claim form

Income Protection

If you would like to make an Income Protection Claim please contact your financial advisor, or call our customer service team on 01 704 1010

Any information provided will be used solely for the purposes of processing your claim.

We will need the following information from you in order to assess your claim:

  • Who is the claim being made on:
  • Plan Number:
  • Plan exclusions:
  • What illness is the claim being made on:
  • Contact name, address and phone number of claimant:
  • Exact date ceased work:
  • Employed or Self-Employed:
  • Any additional information you think would be relevant:
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