Life & Health Quote

Tell us a bit about your business or personal situation and we'll come back to you with a tailored insurance solution. No jargon, no runaround.

Four short sections. Everything you share goes directly to our Life & Health adviser, and nothing is quoted or bound without talking to you first.

Your adviser

Partner, Life & Health

Would you rather talk it through before filling anything in? Call or email Bryce directly.

Fields marked with an asterisk are required. Everything else is optional, and blanks are fine if you are not sure.

So we know who we are talking to and how to reach you.

First name *

Last name *

Email address *

Phone number *

City or town *

Preferred contact method *

Email Phone Either

A rough idea is enough at this stage. We will refine it together once we understand your circumstances.

Type of cover

Tick as many as apply, or tell us you are not sure.

Life insurance Income protection Trauma cover Health insurance Mortgage repayment cover Not sure yet

Date of birth *

Age is one of the main things premiums are priced on.

Amount of cover

Leave this if you would like us to work it out with you.

Smoker status *

Non-smoker Smoker Ex-smoker, 12 months or more

Existing cover changes the advice, so it helps to know what is already in place.

Do you have life or health cover already?

Yes No Not sure

Current insurer

If you know it. If not, leave it blank.

How soon do you need cover? *

Dependants, a mortgage, a business that relies on you, a health condition you would rather raise up front. All of it shapes the advice.

Tell us what matters most

Optional. Write as much or as little as you like.

I am happy for Long Burroughs to contact me about this enquiry, and I have read the Privacy Policy and Legal disclosure. *

Advice is provided by Long Burroughs Financial Services Limited. Nothing you send here puts cover in place.