Ausure Personal Accident Insurance

First Name

Last Name *

What is the weekly benefit amount you would like to be insured for?

Please Select your cover option

This cover is optional and has not be included in your quote.

This section covers any illness or disease which first manifests itself during the period of insurance, subject to exclusions in the policy.

What level of Death and Capital benefit do you need?

This cover is optional and has not be included in your quote.

This section not only covers accidental death (sudden, unexpected, and unusual) but also covers a table of capital benefits for contingencies such as loss of a finger, eye, hearing, paralysis, permanent total disablement.

Occupation 🛈

What is your taxable income per year? *

Postcode *

Age at next birthday

Any advice that may have been given is general advice only, please be aware that we have not taken into consideration your needs, objectives or financial requirements. Before deciding to purchase a financial product you should consider the appropriate Product Disclosure Statement to ensure the product is suitable for your needs.