121 Healthcare Ltd

Request for Primecare Saver policy details from Standard Life Healthcare

To complete your request for the Primecare Saver policy details from Standard Life Healthcare, please complete the details below:

Name:
Address:
Country:
Post code:
E-mail address:
Daytime phone number:
Evening phone number:
Date of birth:
Occupation:
Any additional comments or questions:
I confirm that I have read the guide to buying Private Medical Insurance, that I am a resident of the United Kingdom and that I have checked that the policy details shown on this site meet my requirements. I understand that the period of cover is for 12 months and that I will be asked if I wish to continue with the insurance at the end of that time. I also understand that it is my responsibility to provide complete and accurate information to insurers when I take out an insurance policy, throughout the life of the policy and when I renew my insurance. I understand that it is important that all statements I make on proposal forms, claim forms and other documents are full and accurate. If I fail to disclose any material information to my insurers, I realise that this failure could invalidate my insurance cover and could mean that some or all of a claim may not be paid.

121 Healthcare Ltd,
92 Bath Road,
Cheltenham,
GL53 7JT