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'inSpire' Private Medical Insurance

You're only seconds away from your online quote!

About You

Add Family Members

Relationship:
Name:
Date of Birth:
Gender:

You must ensure that to the best of your knowledge and belief that the information you provide in this application form, and any supplementary information provided as part of this application are accurate, honest and complete. Failure to do so may mean that we cannot cover a claim.

Data Protection - By submitting this form you are agreeing to allow companies within the APRIL Group to contact you about this product and their services. Under no circumstances will the APRIL Group pass your details on to third parties for this purpose.

Your Policy Details

Your Premium

per month

Excess options

People To Be Covered

Reference

Proposed Start Date

Your Cover Includes

Full in-patient and day-patient benefits

Covers procedures where a hospital bed is required for the day, or overnight, such as surgery or an operation.

More Information
Hospital Accommodation and Nursing Care:
PAID IN FULL
Prescribed Drugs and Dressings:
PAID IN FULL
Operating Theatre Fees:
PAID IN FULL
Radiotherapy & Chemotherapy:
PAID IN FULL
Consultations, Radiology, Pathology:
PAID IN FULL
Diagnostic Tests including MRI/CT/PET Scans:
PAID IN FULL
Physiotherapy:
PAID IN FULL
Surgeons, Physicians & Anaesthetists Fees:
PAID IN FULL
Oral Surgery (non dental):
PAID IN FULL
Parent Accommodation:
PAID IN FULL
Prosthesis:
PAID IN FULL

Full out-Patient benefits

Covers procedures where you do not need a hospital bed. This includes specialist consultations and diagnostic testing.

More Information
Specialist Consultations, Pathology, X-Rays, Diagnostic Tests, Physiotherapy:
PAID IN FULL
Physio limited to £500 per policy year
MRI/CT/PET Scans:
PAID IN FULL

Full cancer benefits

Includes a wide range of benefits from initial consultations and diagnostic tests, through to cancer drugs and therapies.

More Information
Consultations and Specialist Fees:
Paid In Full
Diagnostic Tests and Scans:
Paid In Full
Cancer Drugs and Therapy:
Paid In Full
Biological Therapies ('super drugs'):
Paid In Full
(Reviewed after 12 months)
Radiotherapy and Chemotherapy:
Paid In Full
Palliative Treatment:
Up to £10,000
(during the lifetime of the plan)
Wigs:
Up to £100
(during the lifetime of the plan)
External Prostheses:
Up to £5,000
(during the lifetime of the plan)

Other Benefits

More Information
Private Ambulance:
PAID IN FULL
NHS Cash Benefit:
£100 per day/night
(Up to 30 days/nights per policy year)
NHS Cancer Cash Benefit:
£300 per day/night
(Up to 30 days/nights per policy year)

Complimentary Benefits

More Information

Best Doctors – An expert second medical opinion service providing access to the world’s best medical experts.
Discounted Bupa Health Assessment – 25% off a range of medical assessments and expert guidance.

Your Nearest Spire Hospital

Your Underwriting Choice

Your quote is based on Moratorium underwriting. This means any medical issues you have experienced or had symptoms of, at any time in the 5 years prior to the start of cover will not be covered – until you remain 2 consecutive years from the start date completely clear of symptoms, tests or medication for the condition or anything relating to it.

We can also offer Full Medical Underwriting and Continued Personal Medical Exclusions underwriting – however, you’ll need to call our Customer Services Team on 0800 470 4595 to apply by these methods.

Your Summary

Please check the details below are correct as they will be used to form the basis of your policy.

Monthly Cost:
(annual equivalent )
This includes the Insurance Premium Tax (IPT) at the current rate
Excess Amount:
Nil Excess £100 Excess
People to be covered:
Address:
Postcode:
Telephone:
Email:
Proposed start date:

Declaration

Declaration

I hereby apply for insurance with the Insurer for those shown on this application. By clicking Continue to Payment I agree to be bound by APRIL UK's usual terms and conditions contained in the policy document. I understand this application is subject to written acceptance by APRIL UK. Cover will commence once approved and accepted by APRIL UK at which point any special terms relating to your cover will be highlighted. APRIL UK reserve the right to decline any application. You have a statutory right to cancel the policy within 30 days of the policy start date. I declare to the best of my knowledge and belief that the statements made in this application form, and any supplementary information provided as part of this application are accurate, honest and complete. I shall read the terms and conditions of the policy when received and agree to be bound by them.

Please tick this box to confirm that you are a UK resident and registered with a UK General Practitioner

Data Protection Act 1998

I/we confirm and agree that information about me/us and this application form may be retained on paper and computer by APRIL UK and used: a) By Arch Insurance Company (Europe) Limited and other businesses that provide insurance services relating to the policy as may be necessary for the administration of my/our policy and dealing with our claims under my/our policy. I/we agree that it may be necessary for Arch Insurance Company (Europe) Limited to obtain and use sensitive personal information about me/us. b) To provide information about me/us (whether provided in the application form or any claim form) to other insurers for the prevention of fraud.

The information may also be used to send you details about other services available from APRIL UK that might be of interest to you. If you wish to opt out of this service, please tick this box.

Payment Frequency

Your premium is: per month per year

To pay by Direct Debit you confirm that:

  • • You are the policyholder
  • • You are authorised to set up Direct Debits on this account
  • • This account does not require more than one person to authorise Direct Debits

Please click yes to confirm

You can still apply for this policy, however you will need to call us on 0800 470 4595.

Payment Confirmation

Your premium is: per month per year

This includes Insurance Premium Tax at the current rate.

You can pay for the plan by Direct Debit by providing your bank details below.

Direct Debit Details

Direct Debit Instruction and Guarantee

Before you continue please ensure that you have read the Direct Debit Guarantee

Please pay APRIL UK (Insurance Service) Ltd Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this instruction may remain with APRIL UK (Insurance Service) Ltd and, if so, details will be passed electronically back to my Bank/Building society. Bank and Building Societies may not accept Direct Debit instructions for some types of account.

Thank You

Thank you for choosing APRIL UK!

Thank you for your application for the inSpire Private Medical Insurance Plan.

 

What happens next?

Shortly, you will receive an email confirming your policy details. Please check the information carefully and contact us if you have any questions. We’ll also give you a courtesy call to ensure you are happy with the policy chosen. If we are unable to contact you we will continue to process your policy as standard.

We will now process your application and this can take up to 4 working days. Once your application has been accepted, we will email you your Certificate of Registration and Welcome Documents, confirming that your policy has been set up.

Once again, thank you for choosing APRIL UK!

 

Direct Debit Information

This completes the set-up of your Direct Debit instruction and confirms the set-up of your inSpire private medical insurance plan.

Confirmation of the instruction will be sent to you within 3 working days, or be received by you no later than 10 working days before the first collection or by letter or by email if you have requested us to use this method.

Below is the Direct Debit Guarantee for your information.

The Direct Debit Guarantee

  • This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
  • If there are any changes to the amount, date or frequency of your Direct Debit, APRIL UK (Insurance Services) Ltd will notify you 3 working days in advance of your account being debited or as otherwise agreed. If you request APRIL UK (Insurance Services) Ltd to collect a payment, confirmation of the amount and date will be given to you at the time of the request.
  • If an error is made in the payment of your Direct Debit, by APRIL UK (Insurance Services) Ltd or your bank or building society, you are entitled to a full and immediate refund of the amount paid from your bank or building society. If you receive a refund you are not entitled to, you must pay it back when APRIL UK (Insurance Services) Ltd asks you to.
  • You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Need help with this quote call 0800 470 4595

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APRIL UK is a trading name of APRIL UK (Insurance Services) Ltd (registered in England No 3179382), who is authorised and regulated by the Financial Conduct Authority, registration number 308655.