Preliminary Health Application

Please note this is a preliminary questionnaire.
These details are required to be re-confirmed by an Advisor before your policy goes live.
No cover is provided until assessed by an advisor and acceptance is confirmed.​

Any data including bank details you provide is secured and encrypted via SSL and cannot be intercepted by anyone. More than 500,000 customers and hundreds of millions of users in over 180 countries use DocuSign to securely sign documents, Including all major banks in Ireland.

SSL logo
DocuSign Logo

Do You Require Assistance?

Unsure about anything on the form? Click on the Chat Button on the bottom right to Speak to us live or call us for free. We’re always online and available to help.

insurance advisor

Quick Call Back

Enter your details below and a Financial Advisor will call you back promptly.

Contact Info

Coronavirus Covid 19 Information

We would like to assure our customers that although this Worldwide Pandemic has struck our Nation hard, we are still here for our new and existing customers. All phone calls and emails will be dealt with accordingly.

In the unfortunate circumstance that a customer contracts COVID-19 and dies, our life policies would pay out in line with our usual claims philosophy.

All Consultations will be held by Phone or Online via Computer/Smart Device to remove face-to-face interactions and keeping in line with social distancing guidelines recommended by the Government.

We at Lowquotes.ie hope you, your family and your loved ones stay safe & healthy in this time.