Protecting your Lifestyle

(1)

...

Protecting your Lifestyle

Do you have Children?

Age

...

Age

...

Age

Tell me about your Lifestyle - (Hobbies, Home, Holidays, Children)

In an IDEAL world, if your income

stopped yesterday, what impact would

you want this to have on your Lifestyle

& Standard of Living?

Names & Ages

...

Age

Tell me about any plans you have for the future (moving house, jobs, retirement, etc)

What things could happen to affect your lifestyle in a negative way?

What are the CHANCES that any of these things could happen? - (Use Risk Calculator -

www.riskreality.co.uk/intrinsic)

Which RISKS do you want to resolve, and in what order?

Lifestyle Mortgages & Debts

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Beer / Wine / Spirits Cigarettes

Total Fuel - Petrol / Diesel Insurance / Road Tax

Other

Sandwiches & Snacks Newspapers / Magazines Servicing / Repairs

Day to Day Expenses Coffee / Tea

I

Train Fares / Bus Fares

Number per week TRAVEL

DEBTS NOW

Loans / Hire Purchase

I

FUTURE NOW

Total Savings / Pensions / Invesments

Total Other

FUTURE

NOW

Credit Cards / Store Cards Mobile Phones Special Occasions, Xmas LIFESTYLE

Total

Holidays / Weekends / Breaks Restaurants - Dining out

NOW

Insurances- Life, Pet, Income Leisure, Gym, Entertainment

HOME

Mortgage / Rent Council Tax

Clothes Maintenance / Repairs Gas / Electricity Water

Child Care Food / Shopping Other Tel / Broadband / Sky TV

Where your money goes...

Home Insurance

HOME

Expenditure Summary

Hobbies & Interests

TRAVEL LIFESTYLE NOW Average Cost DEBTS

I

Client 1

I

Total DAY TO DAY EXPENSES

Client 1

I

Client 2 FUTURE

I

FUTURE FUTURE #1 #1 Client 2 Cost per month

(3)

Is there a new property? Is there a new property? Annual Gross Income

Monthly Net Income

p.a

Time at Current Address

p.m

Date of Birth Forename(s) How long would you expect to be

dependant upon your partners Income?

Marital Status: Employment Status Job Title

p.m

Total Monthly Net Income

Client 2

Surname How long would you expect your Children to be dependant upon your Income?

Client 2 Other Monthly Income

Title

Do you Smoke? Expected Retirement Age

Income & Dependancy

Personal Details

Client 1

Contact Details

Tel / Mob (Preferred Contact) Address

If less than 3 years - provide Residential Status Postcode

Income & Salary

Client 1 Client 2

Current Disposable Monthly Income p.m #DISP

Employer

p.a

Client 1

National Insurance Number

previous address

(4)

years Mortgage Protection Life Cover

State Benefits (Lump Sums)

D1

Accident & Sickness Policies ISA

Bank & Building Society

Existing Arrangements

Lump Sums paid on Death

Pension Funds (on death) Death in Service

Family Income Benefit Policies Life Assurance Policies

Other Cash

Debts - capture the values of individual debt liabilities, but the TOTAL should be the sum total of ALL debts (client 1 & 2).

Personal Loans

Secured Loans

Lump Sums paid on Death - Enter the value of YOUR Policies where YOU are the Life Assured.

Stocks & Shares

How to use this page:

Critical Illness Policies Other

Cash, Savings & Investments - Enter the values of items which would be available to YOU in the event of Death, CIC, IP

Sick Pay Arrangements - Enter the values of arrangements which would be available to YOU in the event of sickness/incapacity.

Total Lump Sums available in the event of suffering a Serious or Critical Illness. Joint Liabilities

Total Debt liabilites

Serious Illness & Disability Client 1

C

Total additional Income available to you in the event of sickness from work YOUR Total Capital which would be available to you from your Savings & Investments

B2

State Benefits (ESA)

Mortgage Credit Cards / Store Cards Monthly Sick Pay from Employer Income Protection Policies

Debts

Sick Pay Arrangements

Remaining Term

Hire Purchase

B1 Income paid on Death

A1 A2

Cash, Savings & Investments

D2

Total MONTHLY SUM ASSURED of YOUR income producing policies in the event of Death

YOUR Lump Sum Policies & Protection in the event of Death

Client 2

Income Policies paid on Death - Enter the value of YOUR Family Income Benefit policies - where YOU are the Life Assured.

Serious Illness & Disability - Enter the lump sum value of arrangements which would be available to YOU.

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% Rev Prm

Deffered period _months

(IP / ASU / MPPI)

Gtd Prm Rev Prm Waiver Trust? Lifestyle Mortgage

Policy Benefits

(IP / ASU / MPPI) Waiver Indexed Other Lifestyle Mortgage Policy Benefits Gtd Prm % Indexed Other Trust? Frequency months Type of policy

CIC LCIC ASU MPPI Type of policy

(IP / ASU / MPPI) Policy Benefits Policy Benefits Type of policy Policy Benefits Deffered period Rev Prm Waiver

(IP / ASU / MPPI)

DIS

Policy Benefits

Benefit period

Trust? Indexed % Other

Type of policy

CIC LCIC ASU MPPI END IP Client 2 £ Lifestyle Mortgage Joint Other

Rev Prm Waiver Trust? Indexed

Type of policy

% Other

Purpose Lifestyle Mortgage

Gtd Prm Rev Prm Waiver Trust? Premium

Remaining term _years

Sum assured _£

Life Basis Single Joint

(IP / ASU / MPPI) Benefit period

LTA DTA WOL FIB

%

Sum assured

Life Basis Single

Frequency Purpose

Gtd Prm Indexed Owner

WOL FIB DIS IP LCIC ASU MPPI END Client 1

IP LTA DTA

LTA DTA WOL FIB DIS

Type of policy

CIC CIC LCIC ASU MPPI END

Owner Client 1 Client 2

Sum assured

Life Basis Single Joint

£ Purpose

WOL

Life Basis Single

LTA £ DIS END Client 1 Client 2 ASU MPPI IP CIC LCIC Lifestyle Mortgage Rev Prm Gtd Prm

(IP / ASU / MPPI)

Indexed % Other Sum assured

Owner

DTA

Purpose Lifestyle Mortgage

Joint FIB

Waiver Trust?

Premium

WOL FIB DIS IP END Benefit period Life Basis Owner Life Basis years Single Gtd Prm LTA Client 2 £ £ years Client 1 Remaining term Sum assured Client 1 Remaining term Sum assured Client 2 DTA MPPI END DTA LTA WOL CIC FIB DIS Single Joint LCIC Policy 1 Policy 2 Policy 3 Policy 4 Policy 5 Premium Frequency IP Premium Policy 6 Benefit period Joint Purpose Owner ASU

Benefit period Benefit period

Purpose

Details of Existing Policies

Premium Frequency

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B1

A1 B2

Total Available Monthly Residual Income Budget available for Protection Solutions

Is 'lowest price' a key factor when considering our recommendation? YES NO

Budget

Client 1 Client 2 Sub-total Subtract Total Debts

NET cash (minus Debts)

Monthly Income generated from Capital

Total Income on Death of Partner

Period of Sickness Shorfall Need (Ideal - Actual)

#1 #2 12 mths + 0 to 3 #2 3 to 6 12 mths +

SUMMARY ON DEATH (What you would receive, or will have access to)

Actual

-Actual Monthly Income

Ideal

Client 1 Total from Life Policies

Assumed Interest Rate

D2 Total from Cash & Savings

Income from 'Income Policies' Continuing NET Income from Salary

%

Client 1 0 to 3

Ideal Monthly Income

IDEAL, ACTUAL & NEEDS - Sickness & Incapacity

-Period of Sickness Actual Income = 6 to 12 3 to 6 Net Income (Client 2) Client 2 p.m. Net Income (Client 1) 6 to 12 _p.m. Shorfall Actual Income +

IDEAL, ACTUAL & NEEDS - Death

Income A2 p.m p.m p.m p.a. % Income

IDEAL, ACTUAL & NEEDS - Critical Illness

Lump sum

= Disposable Income

Client 1

Need (Ideal + Disposable - Actual)

p.m p.m p.m p.a. D1 #2 Lump sum p.m #2 Client 2

Summary & Shorfalls

Client 2 C

p.m

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Have your biological parents, brothers or sisters have died or suffered from any of the following before the age of 65? – heart disease, stroke, diabetes, cancer or tumour, Alzheimer’s disease, Parkinson’s disease, polycystic kidney disease, polyposis of the colon, motor neurone disease, multiple sclerosis, Huntington’s disease, muscular dystrophy, hypertrophic cardiomyopathy (HOCM) or any other hereditary disorder?

Yes / No Yes / No

If you have answered YES to any of the above questions, please provide further information in the box below: Have you previously had an application for Life Assurance declined, refused, rated, excluded, ever

had any major medical condition and / or surgery, had a medical condition in the last 5 years even if you have not consulted with a medical professional, ever used any form of non prescription drug or narcotic, are currently awaiting the results of a medical investigation or currently taking any form of prescription medication?

Yes / No Yes / No

Do you take part in one of the following hazardous hobbies or pursuits? Aviation, Aviation related, Caving / Potholing, Equestrianism, Motor Sport, Mountaineering, Sailing / Yachting, Sports Diving or any other form of ‘Extreme / Other / Winter’ or professional sport?

Yes / No Yes / No

Client 1

Client 2

Yes / No Yes / No

Are you a non resident in the UK (excluding the Channel Islands and The Isle of Man) and / or have you travelled overseas for a continuous period of more than 90 days in the last 5 years.

Client 1 Client 2

Do you currently work in any occupation that involves any of the following duties, Manual work (e.g. lifting, carrying, working with machinery and tools) driving, working at heights or a member of the emergency services?

Yes / No Yes / No

Are you a member of the Armed Forces, Territorial Army or Reserves? Yes / No Yes / No

What is your Weight (in indoors clothes)?

Client 1 kg

_or

st

Client 2 kg

or

st

What is your Height (without shoes)?

Underwriting Key Questions

Client 1 M

or

ft

(8)

Repay unsecured Debts in the event of CLIENT 2 dying

Need NOT

met Need - N/A

Protect family Lifestyle in the event of death of CLIENT 1

Protect family Lifestyle in the event of death of CLIENT 2

Need Fully Met

Need Partially

Met

Repay unsecured Debts in the event of CLIENT 1 suffering a Critical Illness

Repay unsecured Debts in the event of CLIENT 1 dying

Protect family Lifestyle in the event of Client 2 suffering a Critical Illness

Replace income for CLIENT 1 in the event of Sickness or Incapacity

Replace income for CLIENT 2 in the event of Sickness or Incapacity

Provide a lump sum for Future Aspirational Need 2 (College, University,

House Deposit for Children etc)

Repay unsecured Debts in the event of CLIENT 2 suffering a Critical Illness

Provide a lump sum for Future Aspirational Need 1 (College, University,

House Deposit for Children etc)

Repay Mortgage in the event of CLIENT 1 suffering a Critical Illness during

the mortgage term

Repay Mortgage in the event of CLIENT 2 suffering a Critical Illness during

the mortgage term

16 15 13 14 9 10 11 12

Repay Mortgage in the event of CLIENT 1 dying during the mortgage term

Repay Mortgage in the event of CLIENT 2 dying during the mortgage term

5

6

Date agreed for Next Appointment to review Protection Needs

7 8

Advice Checklist

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