Sample Group Life Insurance Quote Specification

Company Details
Name of Company
Nature of Business
Company Website
Head Office Location (Data should include work postcodes for all members)
Adviser Contact
Adviser Contact Phone Number
Eligibility and Rules
Eligibility / Category 1 –
Category 2 –
Category 3 –
Min/Max Entry Age
Cover Cease Age / 65 or SPA / 75 fixed age / Other
Pension Scheme Take Up (if applicable)
Service Qualification
Salary Definition / Basic Annual Salary
Scheme Basis
Lump Sum Benefit Basis / Category 1 –
Category 2 –
Category 3 –
Dependants Pension Benefit Basis / Category 1 –
Category 2 –
Category 3 –
Escalation Rate (Dependants Pension only)
Definition of Dependants (Dependants Pension only)
Childrens Pension? If yes, please confirm benefit basis.
Temporary Absence Provision / Normal Age of Retirement for illness/injury. 3 years for any other reason.
Cover for Ill Health Early Retirees / YES/NO
Redundancy Cover / YES/NO
Registered or Excepted scheme?
Do any members travel or live abroad? (If so, how many members and where do they travel)
Current Insurer
Current Event Limits
Scheme Anniversary Date
Premium Frequency
Scheme History
Policy Period / Lives / Total Sum Assured
2014/2015
2013/2014
2012/2013
2011/2012
2010/2011
Long Term Absentees –
<50 lives – 1 week;
50-500 lives - 1 month;
Over 500 lives – 3 months
Name / Date of Birth / Salary / Date first absent / Condition
Claims History
Age / Date of Death / Cause of Death / Lump Sum
Medical Underwriting History
Name of Member / Date of Birth / Date Underwritten / Benefit Underwritten for / Decision