Gap in cover explanation form

Please take reasonable care as inaccurate information could result in the insurer not paying out in a claim, or the policy being void.

We will provide your responses to your insurer. If they request any further information, we will let you know.

Important – This form must be completed by the policyholder. If any information you provide doesn’t match the policy details that we hold on file for you, we will write to you requesting you to call us to discuss.