Executive Income Protection Quote

Company-paid income cover for directors, including dividends and pension contributions.

Get Your Executive Income Protection Quote

The company that will own and pay for the policy

Company name*

Business structure*

How long has the business been trading?*

The director or employee whose income is being protected

Name*

Date of birth (DD/MM/YYYY)*

Do you smoke?*

Job title and main duties*

An executive policy can cover salary, dividends, employer National Insurance and pension contributions

PAYE salary (gross, per year)*

Dividends drawn from the business (per year)*

Any other remuneration (P11D benefits, bonuses)

Would you like employer National Insurance and pension contributions covered too?*

Tell us how the benefit should be set up

Monthly benefit you'd like to protect*

How long could the business keep paying you before a claim starts?*

How long should the benefit be paid for on a claim?*

What age would you like the cover to run to?*

Should the benefit rise each year with inflation?

Any sick pay, group scheme or existing income protection in place?

How can we reach you?

Phone number*

Email address*

This helps us find you the right cover

Are you currently off work or working reduced hours due to an accident, injury or illness?*

Have you had Cancer, Heart attack, Stroke, Type 1 / 2 Diabetes or MS?*

Do you take medication for any condition? (please note condition)

Are you waiting any medical tests, appointments or treatment?*