Protection review declined

1. Important information

As part of our commitment to FCA Consumer Duty, we regularly offer clients the opportunity to review their mortgage, protection and insurance arrangements.

The purpose of this review is to help identify whether your current arrangements remain suitable and whether any gaps may exist in the event of death, serious illness, loss of income or other unforeseen circumstances.

You are under no obligation to proceed with any review or recommendation. However, by declining a review or recommendation you acknowledge that circumstances can change and that existing arrangements may not continue to meet your needs.

I have read and understood the above information.

2. Your details

Primary applicant

Full name*

Date of birth*

Email address*

Add a joint applicant.

3. What are you declining?

Select all that apply.

Consumer dutyProtection reviewLife assurance recommendationOther

4. Existing protection arrangements

Do you currently hold any protection policies?*

YesNo

5. Why are you declining?

Please tell us why you don't wish to proceed. Select all that apply.

Additional explanation

Optional but helpful for our records.

6. Understanding of risks

Please confirm you understand each of the following. All boxes must be ticked.

Select all of the statements belowMy family may have insufficient financial support if I die.I may be financially vulnerable if I suffer a serious illness.I could lose income if unable to work due to accident or sickness.Existing policies may not be suitable or sufficient.Future cover may be more expensive or unavailable due to age, health or changes in circumstance.My circumstances may change and should be reviewed periodically.

7. What would prompt a future review?

8. Consumer Duty declaration

I confirm that:

I have been offered the opportunity to review my protection arrangements.
Relevant risks have been explained to me.
I have had the opportunity to ask questions.
I understand the potential consequences of declining the review and/or recommendation.
I have made my decision voluntarily.
I understand I can request a review at any time in the future.

I agree to the Consumer Duty declaration above.

9. Electronic signature

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