Hensure Life : Insurance Brokers and Consultants

Hensure Life, insurance brokers ans consultants

What would happen if you fell ill, critical illness or die?


	Business and Personal insurance you can trust.

COMPLETE THIS SIMPLE FORM AND AN ADVISOR WILL BE IN TOUCH WITH YOU
WITHIN THE NEXT 24 HOURS.

Amount Required £ * Over Years *

Which options do you require?

Accident, Sickness and Unempoyment

Personal Details:

First Name:	*
Surname:	*
Birthdate dd/mm/yy:	*
First line of address:	*
Post Code	*
Smoker:	Yes No .....Smoker and other definitions *

Contact Details:

Home:	Preferred contact *
Work:	Preferred contact
Mobile:	Preferred contact
Email:	Preferred contact *

I have read and understood the Key Facts document *
I have read and understood the DPA statement *

Hensurelife is a trading name of RK Henshall & Co Ltd. RK Henshall & Co Ltd who are authorised and regulated by the Financial Services Authority.
Registration Number - 308865 www.fsa.gov.uk. Written quotations, policy terms, conditions and exclusions are available on request.