Personal Accident Insurance Application

Your price

£- per month

Key Information

Please read these documents before proceeding further

Policy Document

Insurance Product Information Document (IPID)

Terms of Business

Throughout the application journey we will provide you with key information(Policy Document, Insurance Product Information Document (IPID)) about the Personal Accident Insurance product electronically.

You can choose whether you'd like to receive your policy documents by paper or email in the application.

Our application tool can help you work out your Personal Accident Insurance needs and will be based on the information you provide. You'll be able to tailor your cover through completing the application. We will not give you a personal recommendation and this should not be considered as advice.

Eligibility

You must be a serving member of H.M. Forces and aged under 65 years of age.


Please select an option

Your cover:


No more than 30 days from today
Please enter a valid start date (dd/mm/yyyy) in the next 30 days
icon
Family cover includes you and your partner, and any children up to 18 (or 23 in full time education)
Monthly price per unit:
1
2
3
4
5
Individual Cover
£5.04
£10.08
£15.12
£20.16
£25.20
Family Cover
£6.16
£12.32
£18.48
£24.64
£30.80
Maximum Benefit Payable
£30,000
£60,000
£90,000
£120,000
£150,000
The benefit paid depends on the injury and there are exclusions/terms that apply. Full table of benefits can be found in the Policy Documents – please read these before continuing.
1
2
3
4
5
Next

All fields are required, unless stated.

Please select your title
Please enter your first name
Please enter your surname
Please enter your date of birth (dd/mm/yyyy), you must be at least 17 years old to take out a policy.
Please enter your email address
Please enter your contact number

Address

Or, enter your address manually

Please select an address
Please enter the 1st line of your address
Please enter the city of your address
Please enter the country of your address
Next

PMGI Limited, trading as Forces Mutual, would love to keep in touch about the great work we do to support the Armed Forces, our products and latest offers.

Other companies trading as Forces Mutual would also like to let you know about their financial products and services. They are PMHC Limited which offers a healthcare scheme.


Sometimes, a company trading as Forces Mutual may contact you by post or telephone. We will give you the opportunity to choose not to receive further information by that method at the time. You can update your marketing preferences at any time by emailing nomarketing@forcesmutual.org or by calling 0151 242 7640. You can also use these details to ask us to stop contacting you by post and/or telephone.

Please let us know how you would like to keep in touch:


Please answer yes or no to all options.
Next

Forces Mutual (PMGI Limited) uses the information you give us to process your application, provide and manage your product or service, and meet our legal and regulatory obligations. If you choose to proceed, we may also share your information with the organisation providing your product (for example, the insurer, SiriusPoint International Insurance Corporation (UK Branch), who underwrite the policy).

We may also use your information to improve our products and services and, where we are allowed to do so under data protection and marketing laws, contact you about relevant products and services.

We only use your information where we have a valid reason to do so, including to provide our services, meet legal requirements, for our legitimate business interests, or with your consent.

To find out more, including your rights, please click here to view our Privacy Policy

Next

The price and cover details for your chosen policy are shown below. If you are happy with this, have read the policy documents and are happy this cover meets your needs then you can proceed to take out the cover by completing the Direct Debit payment details below.

Your price

You have selected the policy with of cover, which would have a maximum benefit payable of per insured person.

£ per month
(This includes Insurance Premium Tax)

Demands and needs

In choosing this product and the level of cover, you have not received any personal recommendations from Forces Mutual, Coplus, or any other insurer.

Personal Accident Insurance is arranged by Motorplus Limited t/a Coplus and underwritten by Astrenska Insurance Limited.

Personal Accident Insurance – this product meets the demands and needs of someone who wants protection in the event of permanent injury, disablement or accidental death. Cover is provided in accordance with the policy terms and conditions.

You can save and print this information here.

Payment details

To set up your direct debit online you must be the account holder and able to authorise debits from the account.
Please enter a valid sort code
Please enter valid bank account details

The premium will be collected on the first available 1st or 15th of the month. All subsequent collections being collected on the 1st of the month.

Instruction to your Bank or Building Society

Please pay PMGI Ltd direct debits from the account detailed subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with PMGI Ltd and, if so, details will be passed electronically to my Bank / Building Society.

To see the direct debit mandate and guarantee, please click here
Next

By completing your Personal Accident Insurance policy purchase, you are confirming you have read and agree that the following statements below are correct:

  • I understand the content of this completed online application form and I wish to proceed to buy a policy;
  • I confirm that the information I've provided is correct and accurate to the best of my knowledge and understanding;
  • I agree that if the information I've provided should change after I have purchased the policy and during the period of the policy, that I will let Forces Mutual know. (Changes include change of address, cover level and eligibility status as a member of HM Forces or equivalent Ministry of Defence or affiliated organisation);
  • I accept that if the information provided by me is not correct and accurate, my policy may be cancelled or treated as if it never existed, and/or the insurer may refuse to pay all or part of any claim, or it may revise the premium, and/or change any excess, or the extent of the cover;
  • I agree that if the application is accepted, I understand I must pay the monthly premiums for the policy to remain in place;
  • I confirm that I meet the eligibility criteria; as a UK citizen under 65 and a member of HM Forces or equivalent Ministry of Defence or affiliated organisation;
  • I am aware and agree that the premium will be collected on the first available 1st or 15th of the month. All subsequently collections being collected on the 1st of the month. I understand that premiums will be payable until either I or Forces Mutual cancel the policy;
  • I agree that this product matches my demands and needs of providing protection in the event of permanent injury, disablement or accidental death. I understand cover is provided in accordance with the policy terms and conditions;
  • I understand that when I receive my insurance documents, I have 14 days to change my mind and cancel my cover and have my payments refunded (if no claims are made).

It is important you understand all of the Key Information for Personal Accident Insurance and check the cover you are buying to ensure that it meets your needs. We recommend you read all of the policy documents including the Insurance Product Information Document (IPID) before you continue, and keep them in a safe place.

You should also read Our Terms of Business as this provides important information about our service.

Please confirm the above before submitting
Please select an option

Policy Documents


There is no additional charge for selecting either option.