Section 72

Request A Quote

Please complete all of the following details and we will email your Section 72 policy quote to you asap.

Please note: All fields are required to be completed in order to provide you with an accurate quote. Please expect a call from an advisor to discuss your quote with you.

**IMPORTANT** You must be under the age of 75 to start a Section 72 policy.  No cover is available from any provider in Ireland if you are over this age.

Life 1 - Full Name:*
Life 2 - Full Name:
Life 1 - Gender:
Life 2 - Gender:
DD slash MM slash YYYY
DD slash MM slash YYYY
Life 1 - Do you smoke?*
Life 2 - Do you smoke?