PROTECTION FACT FIND CLIENT NAME (S): FACT FIND DATE: AGENDA. Instructions for use: Notes. Area of Need In Scope? Lifestyle. Mortgage and Debts

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1 CLIENT NAME (S): FACT FIND DATE: Instructions for use: Data items in bold are system mandatory i.e. it will not be possible to submit the business in Workbench without this information. If the client has any existing arrangements capture the relevant information ensuring you collect the bold data items as a minimum. AGENDA Area of Need In Scope? Lifestyle Mortgage and Debts Buildings and Contents Income on Death Critical Illness Income on Illness or redundancy Private Medical Insurance Repay on Death Repay on Critical Illness Income on Illness or redundancy Page 1 of 21

2 Personal Details Client 1 Client 2 Title First Name Middle name(s) Surname Preferred name Date of Birth Gender Male / Female Male / Female Marital Status Smoker Are the clients related by marriage/civil partnership? Employment Info Client 1 Client 2 Employment Status Expected Retirement Age Job Title / Occupation Where the client is self employed or a Company Director, do they have the appropriate business protection? Does the employer provide any benefits in kind / pension scheme etc? Page 2 of 21

3 Dependants Client 1 Client 2 Are there any dependents? Dependants details : Names DOBs Relationships Current Address Client 1 Client 2 House Number & Street Are there any plans to move in the future? Town / City County / Country Postcode Residential status Time at this address? New Property Address? House Number & Street Town / City County / Country Postcode Page 3 of 21

4 Previous Address Details (If less than 3yrs in Current Address) House Number & Street Town / City County Postcode Occupancy Type Date you moved in to your previous address? How long did you live at your previous address? Client 1 Client 2 Contact Details Client 1 Client 2 Indicate preferred contact method Home: Mobile: Work: Home: Mobile: Work: Page 4 of 21

5 Existing Arrangements Existing - Life Protection Policies Owner 1 / 2 / Joint 1 / 2 / Joint 1 / 2 / Joint Policy Type LTA / DTA / WOL/ FIB LTA / DTA / WOL/ FIB LTA / DTA / WOL/ FIB When and for what purpose was the policy taken out? Provider Policy Number Remaining Term Sum Assured - Life Lump sum / per annum Lump sum / per annum Sum Assured Critical Illness (if included) Lump sum / per annum Lump sum / per annum Life Basis SL / JLFT / JLSD SL / JLFT / JLSD SL / JLFT / JLSD Who are the trustees and beneficiaries? Purpose Lifestyle / Mortgage Lifestyle / Mortgage Lifestyle / Mortgage In Trust? (If Endowment) Maturity Value Premium and Frequency per per per Does the client have a copy of the policy conditions covered? Details of Critical Illness Conditions covered Page 5 of 21

6 Existing - Stand Alone Critical Illness Policies Owner 1 / 2 / Joint 1 / 2 / Joint 1 / 2 / Joint Policy Type When and for what purpose was the policy taken out? Provider Policy Number Remaining Term Sum Assured Purpose Lifestyle / Mortgage Lifestyle / Mortgage Lifestyle / Mortgage Premium and Frequency per per per Renewal Date Details of Critical Illness Conditions covered Does the client have a copy of the policy conditions covered? Page 6 of 21

7 Existing Mortgage Payment Protection Insurance & Accident & Sickness Policies Owner 1 / 2 / Joint 1 / 2 / Joint Policy Type Disability / Unemployment / Both Disability / Unemployment / Both Have they ever made a claim on the policy? If so when, why and what was the outcome? Provider Policy Number Benefit Amount / Frequency Benefit Period Deferred Period Benefit 2 Amount / Frequency Benefit Period 2 Deferred Period 2 Premium and Frequency per per Renewal Date Purpose Lifestyle / Mortgage / Both Lifestyle / Mortgage / Both Page 7 of 21

8 Existing Income Protection Policies Owner 1 / 2 1 / 2 Policy Type ASU / IPB / Group IPB / Employers Benefit / Multi-benefit ASU / IPB / Group IPB / Employers Benefit / Multi-benefit Have they ever made a claim on the policy? If so when, why and what was the outcome? Provider Policy Number Start Date Does the client have any other form of income in the event of loss of earnings through accident, sickness or redundancy? Benefit Amount 1 Deferred period 1 (weeks) Benefit Amount 2 Deferred period 2 (weeks) Benefits Indexed? Wavier of Premium Included? Frequency of Benefit Payments Benefit payable for a specific number of months, years or until a specific age? Number of Years: or Age: Number of Years: or Age: Premium and Frequency per per Renewal Date Purpose Lifestyle / Mortgage Lifestyle / Mortgage Page 8 of 21

9 Existing Private Medical Insurance Policies Owner 1 / 2 / Joint 1 / 2 / Joint Cover Type Family / Single / Joint / Single Parent Family / Single / Joint / Single Parent Have they ever made a claim on the policy? If so when, why and what was the outcome? Employee benefit or private cover? Employer / Private Employer / Private Provider Premium and Frequency per per Renewal Date Existing Buildings and Contents Policies Cover Type Buildings Contents Property Usage Main Residence / BTL / Overseas Property / UK Holiday home / Unoccupied Accidental Cover Damage Included? Cover Amount Provider Policy Number Premium and Frequency per per Renewal Date Page 9 of 21

10 Replacements Client 1 Client 2 Is the client happy to replace any existing policies that could be replaced more cheaply or no longer meet their needs? If Yes Which policies? If any policy was cancelled, would the client lose any benefits that could not be replaced? Could the client top up any existing policy without further underwriting? Does the client have any family history of critical illness where cancelling existing benefits could leave them potentially uninsured? Monthly Financial Summary Net Income Client 1 Client 2 Net Income Is there any income from any other sources, eg, benefits, pensions, rental income etc? Expenditure Client 1 Client 2 Mortgage and Home Lifestyle Travel Borrowing and Debts Day to Day Expenses Total Monthly Expenditure Spendable Income Client 1 Client 2 Spendable Income See Appendix B if you require a more detailed budget planner Does the client have a budget for their protection needs? Page 10 of 21

11 Client Needs - Lifestyle Lifestyle Income on Death Client 1 Client 2 Policy Type Term / FIB / WoL Term / FIB / WoL Is there anyone that would suffer financially in the event of the client s early death? What is the value of life cover / annual income required? How long would you like the cover to last? How would the client foresee the income generated: Regular monthly income Withdraw any growth from a capital lump sum Draw from as required from a capital lump sum Do you wish the capital to remain intact? Is affordability a key factor when considering our recommendation? What level of lifestyle would you like your dependants to have: Same as now / be able to pay all essential outgoings / pay monthly bills Does the client have any other arrangements they could generate an income from? Does the client have any future events they would like to protect eg, dependant s education, funeral costs etc? Lifestyle - Critical Illness Client 1 Client 2 Cover Type Term / FIB / WoL Term / FIB / WoL What would the impact be on the client(s) if they suffered a critical illness? What is the value of critical Illness / annual income required? How long would you like the cover to last? Is affordability a key factor when considering our recommendation? Page 11 of 21

12 Lifestyle Income on Illness or redundancy Client Needs - Lifestyle Client 1 Client 2 Would the clients have any income in the event of sickness? Cover Type Disability / Unemployment / Both Disability / Unemployment / Both Do they have any savings? What is the monthly income required? Would their employer pay sick pay? If so, how long for? How long would you like the cover to last? How would they pay their bills and how long would this solution last? Is affordability a key factor when considering our recommendation? Lifestyle Private Medical Insurance Client 1 Client 2 Cover Type Family / Single / Joint / Single Parent Family / Single / Joint / Single Parent Why does the client feel that the NHS cover is not sufficient? Is affordability a key factor when considering our recommendation? Page 12 of 21

13 Repay Mortgages & Debts on death Client Needs - Mortgage Client 1 Client 2 What liabilities are there? Do they wish to protect all liabilities? Cover Type Level / Decreasing Level / Decreasing What is the value of life cover required? Is the mortgage on a repayment or interest only basis? Is the mortgage joint or single? How long would you like the cover to last? Is affordability a key factor when considering our recommendation? Repay Mortgages & Debts on Critical Illness Client 1 Client 2 What liabilities are there? Do they wish to protect all liabilities? Cover Type Term / FIB / WoL Term / FIB / WoL What is the value of critical Illness required? Is the mortgage on a repayment or interest only basis? Is the mortgage joint or single? How long would you like the cover to last? Is affordability a key factor when considering our recommendation? Page 13 of 21

14 Mortgage Income on Illness or redundancy Cover Type How long would you like the cover to last? Client 1 Client 2 Disability / Unemployment / Both Disability / Unemployment / Both Would the client like to ensure that their mortgage payments are met in the event of sickness and/or redundancy? Is the client concerned about redundancy? If so why? Is affordability a key factor when considering our recommendation? Is the client interested in adding additional benefits to any of their policies? Client 1 Client 2 Is the client concerned about a rise in premiums? Guaranteed Premiums Indexation Would the client prefer if their policy kept pace with inflation? Waiver of Premium Fracture Cover Specific Critical Illness conditions Other please state Page 14 of 21

15 Trusts Client 1 Client 2 Does the client require any recommended policies to be written in trust where permitted? Have the client s made a will? What is the purpose? If yes, have the clients considered who the trustees and beneficiaries should be? Do the client s understand the benefits of placing the policy in trust? If no, why not? Who would the trustees and beneficiaries be? Page 15 of 21

16 Client Needs Buildings and Contents Policy Type Property Usage Buildings / Contents / Both Main Residence / BTL / Overseas Property / UK Holiday home / Unoccupied House Number & Street (if not main residence) Town / City Postcode Property Type Year House Built Number of Bedrooms Rebuilding Sum Insured required Amount of Contents Cover required Please give details of any specific items to be insured along with their value Is affordability a key factor when considering our recommendation? Is your home for which the insurance will apply... In a police approved neighborhood watch area? Protected by a professionally-installed burglar alarm which is maintained under a current annual service contract? Page 16 of 21

17 Disclosure SCDD given Date: Version No. Fact Find carried out Date: ID and Money Laundering How was the advice provided Face to Face / Non Face to Face How was the client ID d Paper / Exempt / URU Paper / Exempt / URU Are the clients interested in discussing any other areas Financial Planning? Client 1 Client 2 Investing for Retirement / Pensions At Retirement Options Savings and Investments Children s investments Mortgages Long Term Care Tax Planning (including IHT) Will Writing Business Protection Page 17 of 21

18 APPENDIX A UNDERWRITING KEY QUESTIONS The following questions will provide an indication of whether it is likely that further underwriting will be required for your client. Any answer to the following that is Yes indicates that this is likely Does your client 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? Is your client a member of the Armed Forces, Territorial Army or Reserves? Does your client 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? Has your client 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 they ve not consulted with a medical professional, ever used any form of non prescription drug or narcotic, is currently awaiting the results of a medical investigation or is currently taking any form of prescription medication Has the client s 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. Is your client non resident in the UK (excluding the Channel Islands and The Isle of Man) and / or has your client travelled overseas for a continuous period of more than 90 days in the last 5 years.. Page 18 of 21

19 APPENDIX B DETAILED MONTHLY EXPENDITURE HOME BORROWING & DEBTS Mortgage / Rent Personal Loans Council Tax Car Finance Gas / Electricity Credit Cards Water Store Cards Telephone / Broadband Other Home Insurance Service Charge / Ground Rent Repairs TV / Sky / Cable Other Total Home Expenditure per Month Total Borrowing & Debts Expenditure per Month Page 19 of 21

20 LIFESTYLE TRAVEL Child Care Fuel Food Train / Bus fares Clothes Parking Restaurants / Dining Out Car Servicing and MOT Holidays Road Tax Pet Insurance Car Insurance Leisure / Gym / Entertainment / Social Other Christmas / Special Occasions Birthdays Savings / Pensions Children s pocket money Mobile phones Other Total Lifestyle Expenditure per Month Total Travel Expenditure per Month Page 20 of 21

21 DAY TO DAY EXPENDITURE Client 1 Average Cost (amend as required) Number per Week Total Cost Per Week Client 2 Average Cost (amend as required) Number per Week Total Cost Per Week Coffee / Teas 2.50 Coffee / Teas 2.50 Newspapers / Magazines 1.95 Newspapers / Magazines 1.95 Lunch / Sandwiches / Snacks 3.00 Lunch / Sandwiches / Snacks 3.00 Cigarettes 0.35 Cigarettes 0.35 Bottles of wine 5.00 Bottles of wine 5.00 Bottles of beer 2.00 Bottles of beer 2.00 Pub Pub Takeaway meals Takeaway meals Total per Week Total per Week Total per Month ( weekly x 52 / 12) Total per Month ( weekly x 52 / 12) Page 21 of 21