|  1. Start  |  2. Requirements  |  3. Applicant  |  4. Employment  |  5. Contact  |  6. Assessment |

Crossmarketed Income Insurance Sample Form

Below is a snippet that we include on the final page of our finance enquiry forms. The snippet only appears only when certain criteria has been met in relation to the applicant age, income and employment.
Note: If you click the "Yes" option below, you will see the additional information that we require of the applicant in order to better qualify the lead. Also, If the final response from the applicant on the sub-form is "No thanks", or any of the required fileds are not completed, a lead is NOT generated.

Recommended:

Many customers seeking quotes for a home loan have also requested quotes for income protection... Would you also like an obligation-free quote or review of your income protection and/or life insurance needs?

Additional questions relating to Income Protection/Life Insurance

*What is your primary occupation?

*Gender: Male    Female

*Are you a smoker? Yes      No

We will request a quote for a monthly income benefit of 75% of your income (this is the maximum allowed by most insurers).

If you would also like a quote to specifically include a Life Insurance Benefit (lump sum payable on death), you can specify an amount below.

Life Insurance Benefit: $ (optional)

You can discuss other policy benefits, such as Total Permanent Disablement and Major Trauma cover with the Adviser who contacts you.

*I understand that this will generate a completely seperate enquiry and that I will be contacted independently by an income protecion / life insurance specialist with some comparative quotes and to further discuss my needs in this area.

Yes, I get it    No thanks

Please Note: This additional service will have no impact on the outcome of your loan enquiry.

IMPORTANT: We are neither authorised nor licensed to provide finance or financial products and we do not offer any form of credit or other financial advice. All product enquiries and requests for financial and/or other advice on this website are referred to third party, qualified intermediaries - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs.

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