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Insurance
- - Products
  - Life insurance
  - Car insurance
  - Car Hire Excess insurance
  - Home insurance
  - Travel insurance
  - Boat insurance
  - Zurich Private Clients
- - Tools and guides
  - Beginner's guide to Life insurance
  - Life insurance calculator
- - My account
  - Manage my policy
  - Make a claim
- - Need Life Insurance?
  - Up to £100 in vouchers when you buy Life Insurance from Zurich - use 'ZOFFERS100' when you apply.
    Terms & conditions
    
    Protect the planet!
    Until 31 December 2019, we'll plant a tree for every Life or Travel insurance policy bought online.
  - Learn more about how
Saving & investment
- - Products
  - Stocks and Shares ISA
  - Cash ISA
  - Investment account
  - Sterling products
- - Tools and guides
  - Beginner's guide to investing
  - ISA calculator
- - My account
  - Manage my investment
- - Need Life Insurance?
  - Up to £100 in vouchers when you buy Life Insurance from Zurich - use 'ZOFFERS100' when you apply.
    Terms & conditions
  - Get a quote
Pensions
- - Products
  - Retirement account
  - Workplace pension
  - Workplace pension transfer
- - Tools and guides
  - Beginner's guide to pensions
  - Approaching retirement
- - My account
  - Manage my pension
- - Need Life Insurance?
  - Up to £100 in vouchers when you buy Life Insurance from Zurich - use 'ZOFFERS100' when you apply.
    Terms & conditions
  - Get a quote
Tools & Guides
- - Calculators
  - ISA calculator
  - Life insurance calculator
- - Planning tools
  - Financial healthcheck
- - Need Life Insurance?
  - Up to £100 in vouchers when you buy Life Insurance from Zurich - use 'ZOFFERS100' when you apply.
    Terms & conditions
  - Get a quote
Get a quote
- - Need Life Insurance?
  - Learn more about how
- - Investment
  - Stocks and Shares ISA
- - Insurance
  - Life insurance
  - Car Hire Excess Insurance
  - Travel insurance
  - Boat insurance

- - Need Life Insurance?
  - Up to £100 in vouchers when you buy Life Insurance from Zurich - use 'ZOFFERS100' when you apply.
    Terms & conditions
    
    Protect the planet!
    Until 31 December 2019, we'll plant a tree for every Life or Travel insurance policy bought online.
  - Learn more about how
- - Investment
  - Stocks and Shares ISA
- - Insurance
  - Life insurance
  - Car Hire Excess Insurance
  - Travel insurance
  - Boat insurance
Help & support
Existing customers

Income protection and waiver of premium claim form

Details marked with * must be completed in full.

Type of claim:

Income protection

Waiver of premium

Policy number:

Your details

Title of the insured:

First name of the insured:

Last name of the insured:

Date of birth (dd/mm/yyyy):

dd/mm/yyyy

House name or number:

Address line 1:

Address line 2:

Town:

Postcode:

Preferred contact number:

Email address

Confirm email address

Date last worked (dd/mm/yyyy):

dd/mm/yyyy

Details of your claim:

Income protection and waiver of premium claim form

Help and Support

Products

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