Insurance forms

Insurance forms

You'll need to complete the Insurance Application and Personal Health Statement if your insurance has not been accepted under an Automatic Acceptance Limit agreement and you therefore need to be individually underwritten.

If you have any queries in relation to any of these forms please contact our client services team on 1800 333 900.

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Abnormal Pap Smear PDF File (537.0 KB)
Alcohol Consumption questionnarie PDF File (557.0 KB)
Anaemia questionnaire PDF File (440.3 KB)
Application for Insurance PDF File (206.8 KB)
Arthritis or Gout questionnaire PDF File (581.7 KB)
Asthma, Bronchitis or Respiratory Condition questionnaire PDF File (606.9 KB)
Bankruptcy, Liquidation, Receivership or Administration Statement PDF File (461.2 KB)
Chest Pain questionnaire PDF File (584.5 KB)
Confidential Risk Profile questionnaire PDF File (678.7 KB)
Diabetes mellitus questionnaire PDF File (402.0 KB)
Diabetes or Raised Blood Sugar Levels questionnaire PDF File (697.4 KB)
Drug Use questionnaire PDF File (472.9 KB)
Ear or Eye Condition questionnaire PDF File (537.7 KB)
Eczema, Dermatitis, Psoriasis or any other Skin Condition PDF File (580.0 KB)
Epilepsy and Seizures questionnaire PDF File (573.5 KB)
Fast-Check Report PDF File (785.0 KB)
Financial questionnaire for Group Insurance PDF File (640.0 KB)
General Medical Condition questionnaire PDF File (549.5 KB)
Gynaecological Condition PDF File (538.5 KB)
Health Declaration PDF File (641.9 KB)
Heart or Circulatory Condition questionnaire PDF File (559.9 KB)
Hepatitis PDF File (440.2 KB)
High Blood Pressure questionnaire PDF File (563.8 KB)
High Cholesterol questionnaire PDF File (521.3 KB)
Insurance Application – Life Events PDF File (123.5 KB)
Insurance Application – Top-up default PDF File (119.7 KB)
Insurance opt in form PDF File (45.7 KB)
Kidney, Urine, Prostate or Bladder Condition questionnaire PDF File (559.8 KB)
Lump, Skin Lesion, Cyst, Growth or Mole questionnaire PDF File (526.5 KB)
Medical Evidence Authority PDF File (328.5 KB)
Medical Examiner's Confidential Report PDF File (1.7 MB)
Medical/Pathology Request PDF File (742.0 KB)
Mental Health questionnaire PDF File (558.3 KB)
Musculoskeletal or Joint Condition questionnaire PDF File (607.3 KB)
Non-smoker declaration PDF File (534.6 KB)
Occupational Duties Questionnaire PDF File (92.8 KB)
Sleep Apnoea PDF File (540.1 KB)
Sports and Pastimes questionnaire PDF File (771.2 KB)
Stomach or Bowel Condition questionnaire PDF File (610.4 KB)
Thyroid questionnaire PDF File (621.4 KB)
Transferring your insurance cover PDF File (107.5 KB)
Travel and Residency PDF File (559.9 KB)
Underwriting Application Declaration (>90 days) PDF File (596.8 KB)