Twins and multiple births insurance

SISA

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Twins and multiple births insurance

Choice of sum insured from £1000 to £5000
Quotation provided automatically for £1000, £2000 £3000 or £5000
Double benefit for more than two children
Doctor's certificate will be provided and is required to be completed before cover can be arranged

Cover will not be available if multiple birth follows use of any fertility treatment or fertility enhancing drug

Cover must be arranged before first scan and within first 10 weeks of pregnancy based on British Pregnancy Advisory Service timetable. We may be able to arrange cover until the 14th week, but the premium will be higher.
Typical Premiums

Ł40 per Ł1000 cover with no history

Ł200 per Ł1000 cover with long history

If you would like to receive a free "no obligation" quotation via email please submit the form below

Please include as much information as possible in order for us to provide you with a quotation for appropriate cover at the minimum premium.

Please allow at least a week to obtain and accept a quotation, or longer if your doctor would not complete the insurer's Doctor's Certificate within 24 hours of your request.

Data Protection Act, 1984. Your details will be stored on computer, only to handle your enquiry.

Please note: 'Mother' means expectant mother, (not the mother of the expectant mother) and 'Father' means expectant father

All boxes MUST be completed, or we will be unable to provide a quotation

Applicant's Full Name (State relationship to Mother)

Postcode

Address

Daytime Tel. No

Fax (if available)

Amount of benefit required (Minimum Ł1,000 increased in units of Ł1000 up to Ł5,000)

Mother's Name (if not applicant)

Mother's occupation

Mother's age and D.O.B.

Father's occupation

Was the mother's father a twin?

Were either of the mother's grandfathers a twin?

Expected date of birth

Were the mother, father or any of their parents or grandparents adopted?

Give details of any other multiple births in the mother's or father's family.

Only go back as far as your grandparents, and include the following relations: previous children, parents, grandparents, great uncles and aunts, brothers and sisters, uncles and aunts, cousins, nieces and nephews.

Instances where a miscarriage has occurred during a multiple pregnancy or any children which did not survive should be included. If mother, father, or their parents or grandparents were adopted and this information is not known, please state.

Mother's side

Father's side

How many children has the mother given birth to?

Have you had, or are due for a scan? If Yes, on what date are you due for a scan?

Have the mother and/or father received any fertility treatment within the last 24 months? If Yes, please give details

Has a doctor or any other medical professional indicated that a multiple birth is likely or have you any other reason to think that you have a higher chance than average of a multiple birth? If Yes, please give details

A claim will not be paid if:
the birth is more than 6 weeks before the expected date of birth unless medical evidence is provided to show that the growth and development of the babies equates with the expected date of birth.

Declaration

To the best of my knowledge and belief, the statements that I have made in this application are true and complete. If any of these statements are in someone else's writing, he or she acted as my agent for this purpose. I would like Underwriters to use these statements to form an Insurance Contract between us. I agree to accept their policy subject to its terms, conditions and exceptions.

Name of person completing the form, who agrees that the answers given are truthful and will be used as the basis for an insurance policy if premium and terms are acceptable:

Underwriters reserve the right to refuse to accept any application

1 This summary is representative of the cover which is available from one or more but not necessarily all of the featured administrators
2 You should check the cover offered to make sure it meets your minimum requirements
3 SISA does not 'guarantee' either the featured administrators or their cover
4 If you are unable to obtain a satisfactory response from any featured administrator you may e-mail your enquiry to info@sisa.co.uk. You will be asked to pay an enquiry charge.