(b) About the money borrowed (required for each policy and product included on your claim)

Transcription

1 (b) About the money borrowed (required for each policy and product included on your claim) Please note: If you wish to make a claim about the mis-selling of your PPI for more than one product or policy (for example if you have multiple loans or credit cards or if you have a loan and a credit card), you will need to complete another copy of sections b, c and d for each product or each PPI policy. These sections are available in the extra information form online and you can either download and print this out or photocopy these sections of the questionnaire before filling it out. 5. What was the PPI policy sold to cover? A credit card A store card A personal loan A business loan A mortgage An overdraft A loan secured on your home Not sure Was the product selected above a joint borrowing? Yes No If yes, please ensure you complete Q3 and your Partner s details in Q14-Q18 What was the sort code for this product? (if applicable) - - What was the card / account number for this product? This account number will be different to the PPI policy number 6. Which Barclays business did you purchase PPI from? For example Barclays Bank, Barclaycard, Woolwich, Firstplus, Goldfish, Egg, Littlewoods, Hilton, IHG or other If known, what was the policy number of the PPI policy you are claiming about? When did you take out the PPI policy? Please try to be as accurate as possible Or If you can t remember tick here 7. What did you borrow the money or take credit for? Essential spending (for example rent, household bills, food shopping) Non-essential spending (for example buying a new TV, paying for a holiday) Business loan Refinancing or consolidating other debts (please fill in the sections below) What were the names of the Were they loan or How much did When did you When did you companies you had debts with? credit card debts? you owe? take them out? pay them off? Other, please give details below 8. Have you ever missed payments or gone into arrears on this borrowing? Yes No If yes, please give details below. For example how many times you missed payments and by how much, what s your current situation? Are you currently in financial difficulty? Yes No

2 (c) About the sale of PPI (required for each policy and product included on your claim) Please note: If you wish to make a claim about the mis-selling of your PPI for more than one product or policy (for example if you have multiple loans or credit cards or if you have a loan and a credit card), you will need to complete another copy of sections b, c and d for each product or each PPI policy. These sections are available in the extra information form online and you can either download and print this out or photocopy these sections of the questionnaire before filling it out. 9. How was the PPI policy sold to you? You might have been sold the insurance at a different time to when you took out the loan or credit During a phone conversation During a meeting Over the internet You were given a leaflet to fill in By Post Can t remember Other, please give details below Did a member of staff give you advice or recommend that you take out the PPI policy? Yes No Can t remember 10. What is the current situation with the PPI policy? The insurance is still running The insurance was cancelled early The insurance ended when the loan was paid off or when the credit card / bank account was closed Don t know If cancelled, please provide the cancellation date below Or If you can t remember tick here If you wish to give further information, please use the space below. For example you thought the policy had been cancelled but it was not 11. Have you ever made or attempted to make a claim on the PPI policy? For example when you were sick or when you were made unemployed Yes No If yes, please give details below The date of your claim and how long you needed to claim for Length of claim If your claim was rejected please give us the date of the rejection Please use the box below to tell us why you needed to claim or why the claim was rejected. For example, you were made unemployed Please enclose copies of any paperwork you received from the insurer about this claim

3 12. Please give us more detail about the sale of the product you are claiming about. For example please tell us any details you remember about: a) Where the sale took place and who you spoke to at Barclays, Barclaycard or one of Barclays partner companies b) The information you were given before you took out PPI c) How the cost, benefits and terms of the insurance were explained to you d) The questions you asked or advice you were given before taking out PPI e) Why you decided to take out PPI Please send us copies of any policy documentation or credit agreements you may have from when you took out PPI. 13. Please tell us why you are unhappy with PPI, or use this space to continue your answers to any previous questions where you may have run out of space.

4 (d) About your personal circumstances (required for each policy and product included on your claim) Please note: If you wish to make a claim about the mis-selling of your PPI for more than one product or policy (for example if you have multiple loans or credit cards or if you have a loan and a credit card), you will need to complete another copy of sections b, c and d for each product or each PPI policy. These sections are available in the extra information form online and you can either download and print this out or photocopy these sections of the questionnaire before filling it out. 14. At the time you took out the PPI policy, what was your employment status and that of your partner if claiming on a joint policy? Your employment status Your partner s employment status Full time work Part time work 1 Full time work Part time work 1 Temporary/Agency Student 2 Temporary/Agency Student 2 Unpaid work Retired 3 Unpaid work Retired 3 Unemployed Self-employed 4 Unemployed Self-employed 4 Other Other If you were employed, were you receiving national If they were employed, were they receiving national minimum wage? minimum wage? 1 If you worked part time when you took out the PPI policy how many hours did you work each week? 1 If they worked part time when you took out the PPI policy how many hours did they work each week? 2 If you were a student in full or part time education were you also employed? 2 If they were a student in full or part time education were they also employed? If yes, how many hours did you work each week? If yes, how many hours did they work each week? 3 If you were retired please tell us the date you retired or at what age you retired Or Age 4 If you were self-employed please provide details below including if you were also a director of your own company 3 If they were retired please tell us the date they retired or at what age they retired Or Age 4 If they were self-employed please provide details below including if they were also a director of their own company If your employment status has changed since you If their employment status has changed since you took out the PPI policy, please give details below. took out the PPI policy, please give details below. For example, if you were self-employed but are For example, if they were self-employed but are now employed, or you have now retired * now employed, or they have now retired * * If you have retired since taking out the PPI policy tell us the date or at what age you retired Or Age * If they have retired since taking out the PPI policy tell us the date or at what age they retired Or Age

5 15. What type of work did you do when you took out the PPI policy? Your employment type Employer s name or trading name if self-employed Your partner s employment type Employer s name or trading name if self-employed Job title Job title Type of work Type of work Was this Public Sector / Civil Service employment? Was this Public Sector / Civil Service employment? What was your take home pay? What was their take home pay? Was this weekly / monthly or other? Was this weekly / monthly or other? How long had you been working with your employer at the time you took out the PPI policy? How long had they been working with their employer at the time you took out the PPI policy? Years Months Years Months 16. If you were employed at the time you took out the PPI policy, would you have received any pay from your employer if you were off work due to sickness or had an accident or if you were made redundant? Your employment benefits Yes No Can t remember Not relevant (as you were not employed) Your partner s employment benefits Yes No Can t remember Not relevant (as they were not employed) If yes, please confirm the benefit details below. If yes, please confirm the benefit details below. Sick Pay* Yes No Sick Pay* Yes No Full pay Months Weeks Half pay Months Weeks Full pay Months Weeks Half pay Months Weeks Redundancy** Yes No Redundancy** Yes No Total months of salary Total months of salary Other please give details below Other please give details below *payment you would have received if you were unable to work due to sickness, excluding statutory sick pay. **payment you would have received if you were made redundant, excluding statutory redundancy pay. *payment they would have received if they were unable to work due to sickness, excluding statutory sick pay. **payment they would have received if they were made redundant, excluding statutory redundancy pay.

6 17. When you took out the PPI policy, did you have any other means of making your repayments if you were unable to work through sickness, accident or unemployment? Your savings, assets or other insurances Your partner s savings, assets or other insurances Other insurance (income protection, critical illness or life cover) Other insurance (income protection, critical illness or life cover) Insurance policy type Insurance policy type Name of insurance provider (Barclays customers only) Name of insurance provider (Barclays customers only) Savings (held with Barclays or other financial organisations) Savings (held with Barclays or other financial organisations) or more or more Can t remember Can t remember Savings held with Savings held with Barclays Other Barclays Other Additional Income (rental property, redundancy payment) Additional Income (rental property, redundancy payment) or more or more Can t remember Can t remember Additional income provider Additional income provider Would you have used any of these means to make Would they have used any of these means to make the re-payments if you were unable to work through the re-payments if they were unable to work through sickness, accident or unemployment? sickness, accident or unemployment? 18. At the time you took out the PPI policy, did you have any health problems, pre-existing medical conditions or were you registered disabled? Your health Your partner s health If yes, please tell us details below of the pre-existing medical condition, health problem or disability* *This information will be kept confidential and will not be used for any other purpose. If yes, please tell us details below of the pre-existing medical condition, health problem or disability* *This information will be kept confidential and will not be used for any other purpose. Did we discuss your health at the time of sale? Did we discuss their health at the time of sale? Have you ever been off work because of the condition? Have they ever been off work because of the condition?