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Apply for insurance online

Use this form if you want to apply for Death, Total and Permanent Disablement (TPD) and/or Income Protection insurance online. If you have any questions, call us on 1800 222 071 between 8am and 8pm weekdays.

For help choosing your level of cover, or to see the costs of your cover, use the Insurance cover and cost calculator.


What insurance are you applying for*? Tick as many as apply.
What waiting period would you like on your IP (if aplicable)?

* Required field.

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