Group life form 2

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About you > Confirm eligibility > Your enquiry

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Confirm your eligibility for an online quote

[/vc_column_text][vc_empty_space height=”20px”][vc_column_text]Our online quote system with AIG Life is designed to allow you to get a quote, quickly and hassle-free, online. However, in some higher-risk cases, we may not be able to do this online and a member of our team will need to contact you directly to complete the quotation process.

To proceed online, please confirm that:

Cancer, Cardiomyopathy, Chronic lung disease / COPD / Emphysema, HIV/AIDS, Huntington’s disease, Kidney failure, Liver disease, Motor Neurone Disease, Organ transplant, Parkinson/Alzheimers

Heart bypass/valve replacement, Multiple sclerosis, Paralysis/paraplegia, Stroke, Heart attack / Heart disease, Covid-19 – currently (or previously) hospitalised

Afghanistan, Burkina Faso, Burundi, Central African Republic, Chad, Egypt, Eritrea, Iraq, Lebanon, Libya, Mali, Mauritania, Niger, Pakistan, Palestinian Territory, Somalia, South Sudan, Syria, Tunisia, Yemen

Afghanistan, Burkina Faso, Burundi, Central African Republic, Chad, Egypt, Eritrea, Iraq, Lebanon, Libya, Mali, Mauritania, Niger, Pakistan, Palestinian Territory, Somalia, South Sudan, Syria, Tunisia, Yemen[/vc_column_text][vc_empty_space][vc_row_inner][vc_column_inner width=”1/4″][/vc_column_inner][vc_column_inner width=”1/4″][vc_btn title=”Confirm and proceed online” style=”flat” color=”blue” size=”lg” align=”center” link=”url:https%3A%2F%2Fwww.broadstone.co.uk%2Fsme-form-gl-step-3%2F”][/vc_column_inner][vc_column_inner width=”1/3″][vc_btn title=”Cannot confirm – contact me offline” style=”flat” color=”blue” size=”lg” align=”center” link=”url:https%3A%2F%2Fwww.broadstone.co.uk%2Fthank-you-group-life%2F”][/vc_column_inner][vc_column_inner width=”1/6″][/vc_column_inner][/vc_row_inner][/vc_column][/vc_row][/vc_section]