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Group Medical Insurance

 

If you would like to know how your company can benefit from Corporate Private Medical Insurance and the reassurance it provides; please complete the following information and we will prepare a full and personalised Private Medical Insurance quotation for you.

The more information that you can provide, the more able we are to find you the right private healthcare plan for you at the best value.

Fields with an asterisk (*) are obligatory.

Contact details
Company name: *
Nature of business:  
Title: *
First name: *
Surname: *
Address line 1: *
Address line 2:  
Post town / city: *
County:  
Postcode / Zipcode: *
Telephone number: *
    Provide alternative numbers
E-mail address: *
Web address:  
Your requirements
Please select the maximum excess you would consider if it helped reduce your premiums:  
When would you like your insurance cover to commence?  
Number of employees to be insured? *
Existing insurer (if any):  
Type / Name of policy:  
Renewal date:  
Chase Templeton Ltd's office hours are Monday to Friday, 9:00am to 5:15pm
What is the best time to call you?  
Other areas of interest
Please check any other areas of interest:
Private Medical Insurance
Employee Assistance Plans
Absence and Sickness Management
Occupational Health Plans
Stress Management and Counselling Services
Health Screenings
Healthcare Trusts
Third Party Administration
Company Paid / Voluntary
UK and International Insurance
Group Leaver Options
Group Life Insurance
Group Income Protection
Group Dental Plans
Group Cash Plans
Other Corporate General Insurance Services (Fleet/Buildings/Liability)
Would you be happy for Chase Templeton to contact you via email with any promotions or new plans offered by insurance companies we feel would be of benefit to you? *
Yes  No 
Use of your information will be solely used by Chase Templeton Ltd and any personal information provided by you will remain confidential. Your information will not be disclosed to any third parties and our website is secure to ensure your privacy is protected.
Further information
Additional notes:

By supplying us with personal information you will be agreeing to our terms of business and Key Facts about our services.

1. Commencement of Terms of Business

These terms of business will commence on the date of their receipt.

2. Regulation & Status

Chase Templeton Limited of Suite 16, Blackburn Enterprise Centre, Furthergate, Blackburn BB1  3HQ, Authorised and Regulated by the Financial Services Authority. Chase Templeton Limited FSA Register number is 311612. You can check this on the FSA's Register by visiting the FSA's website www.fsa.gov.uk/register or by contacting the FSA on 0845 606 1234.

3. Ownership & Links

Chase Templeton Limited is a wholly owned subsidiary of Chase Templeton Group Limited who also wholly own 1U Ltd a provider of a range of protection insurances, whose policies may be recommended, where suitable.

4. Financial Objectives (Demands & Needs)

Following the issue of these terms, any subsequent advice or recommendation offered to you will be based on your stated objectives (demands & needs), acceptable level of risk and any restrictions you wish to place on the transaction. Details of your stated objectives will be included in the insurance demands & needs statement, we will issue to you to explain and confirm the basis of our recommendation and point out any key disadvantages. There may be exceptions to this, for example, business transacted on a non-advised or execution only basis (directly on your instructions whereby you will not have requested nor received advice, or where pre-prepared questions are used to determine the product and provider) or on a restricted advice basis (the firm’s recommendations were restricted by the fact that not all relevant information was made available). If these situations exist, we will make it clear to you in any subsequent correspondence; however you will appreciate that our responsibility to you will be limited accordingly.

5. Annual Renewals

Prior to renewal of your policy, you will receive a renewal documentation pack in respect of your policy.  If you take no further action on receipt of the renewal pack and premiums are paid and up to date, then any policies in place will renew on the terms outlined in the renewal documentation (which you will receive in advance of the annual renewal date).  However, you should be aware that any annual renewal constitutes a new contract with the insurance provider and you will be entering into this new contract on a non-advised basis having received no advice from Chase Templeton.  This will be reflected in our Key Facts about our Services and Demands and Needs Statement issued to you following renewal.

6. Accurate disclosure of all material facts

It is your responsibility to provide complete and accurate information to insurers when you take out your insurance policy, throughout the life of your policy, and when you renew your insurance. It is important that you ensure that all statements you make on proposal forms, claims forms and other documents are full and accurate. Please note that if you fail to disclose any material information to your insurers, this could invalidate your insurance cover and could mean that part or all of a claim may not be paid. (If you are in doubt as to whether a fact is material or not you should disclose it)  Your attention is particularly drawn to the importance of the Declaration and signature on Insurers proposal forms.

7. Services / Restrictions

Please see our “key Facts about our Services” document which explains the services available, otherwise we shall assume that no restrictions apply.

8. Payment for Services

Please see our “key Facts about our Services” document which explains the options available.

9. Ceasing premiums

In certain circumstances, if regular premium payments are stopped in the early years, then this could result in us having to reimburse commission to the product provider concerned.  We therefore reserve the right to recover from you any balance of commission which may be outstanding.

Chase Templeton Limited retains rights to all initial, and renewal commissions payable in respect of business transacted for you, and you shall not permit or suffer payment of such commission to any other party after termination of your instruction to us.

10. Client Instruction

We prefer that any instructions be given in writing. If any advice, request for instruction or instructions are given orally, then they must be confirmed in writing, to avoid possible disputes. We may refuse at our discretion to accept certain instructions, although such discretion will not be exercised unreasonably.

11. Conflict of interest & material interest

Occasions can arise where we, or one of our other clients, may have some form of interest in business, which we are transacting for you. If we become aware that our interests or those of one of our other clients conflict with your interests, we will inform you and obtain your consent before we carry out your instructions.

12. ID Verification

As part of our regulatory duties, we are required to verify certain documentation. We are unable to forward any applications or money to third parties/product providers until our verification requirements have been met. We take no responsibility for any delay where Identity Verification is outstanding.

13. Receiving payments from clients

Chase Templeton Limited does not handle client monies. We never handle cash or accept a cheque made out to us unless it is a cheque in settlement of our charges or disbursements which we have previously disclosed to you (normally through a fee agreement). Crossed cheques should only be made payable directly to the insurance company and to the relevant third party for various ancillary fees. You should decline to give any money to, or write cheques payable personally to an individual adviser. Individuals that represent Chase Templeton Limited are not to handle client money and any receipt by them personally of such a payment from you will not be regarded by us as being a transaction for which we will have any responsibility.

14. Complaints Procedure

The firm maintains an internal written complaints procedure, details of which are available on request. If you have a complaint (whether oral or written) about the firm or a service it has provided then this should first be directed to our complaints officer at the address shown in our “key Facts about our Services” document. We promise to deal with your complaint in a fair and objective manner.

15. Introductions

There will be occasions when clients are introduced to us from third parties, for example accountants or solicitors.  Under such circumstances, we may rebate part of the commission we receive back to the introducer, as payment for making the introduction. The responsibility for disclosing this payment will be with the introducer.

16. Cancellation Rights (New Policies)

Detailed in your policy document are your rights to cancel your insurance under what is commonly known as a ‘cooling off’ period. Depending on the type of policy you have purchased, you may be entitled to cancel within 14 or 30 days of either conclusion of the contract or receiving your policy documentation, whichever occurs later. For policies under 1 month duration (such as travel policies) there is no right to cancel. Please check your policy Terms and Conditions for full details of your cancellation rights under the policy.

17. Cancellation of Existing Policies

If you are replacing existing policies with cover from a new insurance provider, then it is incumbent on you to ensure any redundant policies are fully cancelled. This includes the need for you to cancel any Bank Direct Debit Mandates that may be in place. Chase Templeton cannot be held responsible for any overpayments made by you due to non-cancellation of these redundant polices.

18. Termination

Termination is without prejudice to any transactions already initiated, which will be completed according to these terms of business unless otherwise agreed in writing. You may terminate your instructions to us at any time. We reserve the right to require such termination to be in writing. We may terminate this agreement by giving you a minimum of fourteen days notice. No penalty shall be payable on any termination but we shall be entitled to remuneration for work undertaken prior to such termination. Any such termination shall be subject to completion of any transactions, which are in progress at that time.

19. Additional information: Distance Communications

Where you are likely to do business with us at a distance i.e. we communicate exclusively by telephone, post, email or fax then it is very important that you read the following points:

  • The firm will provide you with a service as detailed in our Terms of Business and “key facts about our services” documents (Please read carefully)
  • The total price that we charge for our services is set out in our “key facts about our services” document, please ask us if you unsure as to any aspect of our pricing. There will be other charges and expenses imposed by the providers of insurance products which will be detailed separately.
  • Please note there is the possibility that other taxes or costs may exist that are not paid through the firm or imposed by it.
  • There are no specific additional costs imposed by the firm for dealing exclusively at a distance.
  • Please take care to read the warnings issued in any provider literature. If you are unsure then please ask us to explain more detail.
  • The firm does not place any specific limitations on the period for which the information provided remains valid. If you are unsure if something still remains valid then please ask and we will clarify.
  • Please see our “key facts about our services” which sets out how we will charge for, and deliver our service.
  • This contract will exist until terminated by either party.
  • The provisions of this Agreement and the relationship created by it shall be governed by English Law and subject to the exclusive jurisdiction of the English courts.
  • This contract is supplied in English Language and will be communicated in English Language
  • Any cancellation provisions are detailed in the provider product literature.

20. Records & Data Protection Act 1998

Under the Data Protection Act 1998 [DPA 1998], you or your appointed agent, have a right to inspect computer (and certain manual) records relating to yourself and your transactions through ourselves and where appropriate have it corrected or deleted.  All such requests for information must be referred to the Data Protection Officer. As we treat all our clients’ records as confidential, we reserve the right to give you copies of your records, where in certain circumstances to release the original would compromise other clients’ confidentiality or where access to your data is necessary to protect your privacy.  You do not have the right to demand access to data for any other purpose.  So that we may fully understand your circumstances and requirements, Chase Templeton Limited will need to collect information about you, which we will hold as Data controllers under the DPA 1998.  Chase Templeton Limited will use this information to analyse your current and future financial needs so that we can ensure that any subsequent advice is suitable to your particular circumstances.

You agree that Chase Templeton Limited may on occasions use your personal details or share your information with other carefully selected organisations, so that they, or we can inform you of other products and services which may be of interest, either by telephone, post, or other appropriate methods. Our regulator the FSA requires us to keep records of our business transactions for minimum periods of time depending on the transaction, type. However, we will not keep records longer than is necessary.  Where other companies and / or third parties provide services to Chase Templeton Limited, then circumstances may arise which warrant the disclosure of more than just your basic contact details. On these occasions, such as processing business and obtaining compliance and regulatory advice, you are aware that sensitive personal information (for example health details) held by us may be disclosed on a confidential basis to such companies. You also agree that for the purposes described above your data may be transferred to countries outside the European Economic Area (EEA).

21. Express request to receive updates and information on new products and services

You are giving an “express request” to receive telephone calls and other appropriate forms of contact relating to other products and services which may be of specific interest. You agree to your consent lasting for a period of 5 years at which point we will look to review the situation.  If at any point you wish to cancel this consent you can simply inform us in writing or by telephone and we will alter our records accordingly. We shall only contact you during working hours. We will not however contact you at times or places when or where you have advised us not to make such contact.

22. Law

The provisions of this Agreement and the relationship created by it shall be governed by English Law and subject to the exclusive jurisdiction of the English courts.

YOUR CONSENT TO THESE TERMS

By taking out the arranged contract and not cancelling, you are consenting to these terms and giving your express request to receive updates and information.  You hereby authorise the holding of your information, and transfer of information between such third parties when warranted, as described above, on a confidential basis. I/We authorise Chase Templeton Limited to act on my/ our behalf.

If you are unhappy with any aspect of these terms or wish clarification on any aspect please contact us on 01254 504910 or call in to our office to discuss.

Note: If you change your mind, in the future, and decide you no longer wish to receive marketing information from us, or for us to disclose information about you to other parties for marketing purposes, simply tell us when you next call, or write to us.

I have read, understood and accepted the terms of business above *

1. The Financial Services Authority (FSA)

The FSA is the independent watchdog that regulates financial services. It requires us to give you this document. Use this information to decide if our services are right for you.

2. Whose products do we offer?

We offer products from a range of insurers for private medical expenses insurance, term assurance, critical illness and permanent health insurance.

We only offer products from a limited number of insurers for buildings & contents insurance, travel insurance, dental insurance and accident, sickness & redundancy insurance contracts. Ask us for a list of the insurers we offer insurance from.

3. Which service will we provide you with?

We will advise and make a recommendation for you after we have assessed your needs for private medical expenses insurance, term assurance, critical illness, permanent health insurance, buildings & contents insurance, accident, sickness & redundancy insurance contracts, dental insurance and travel insurance contracts.

4. What will you have to pay us for this service?

No fee for advising on and arranging private medical expenses insurance, term assurance, critical illness, permanent health insurance, buildings & contents insurance, accident, sickness & redundancy insurance contracts, dental insurance and travel insurance contracts.

You will receive a quotation which will tell you about any other fees relating to any particular insurance policy.

5. Who regulates us?

Chase Templeton Limited, Suite 16, Business Enterprise Centre, Furthergate, Blackburn BB1 3HQ, Authorised and Regulated by the Financial Services Authority. Our FSA Register number is 311612.

Chase Templeton Limited permitted business is arranging and giving advice on Insurance.

You can check this on the FSA’s Register by visiting the FSA’s website www.fsa.gov.uk/register or by contacting the FSA on 0845 606 1234.

6. What to do if you have a complaint

If you wish to register a complaint, please contact us:

In writing:
Write to Complaints Department, Suite 16, Blackburn Enterprise Centre, Furthergate, Blackburn BB1 3HQ.

By phone:
Telephone: 01254 504910

If you cannot settle your complaint with us, you may be entitled to refer it to the Financial Ombudsman Service.

7. Are we covered by the Financial Services Compensation Scheme (FSCS)?

We are covered by the FSCS. You may be entitled to compensation from the scheme if we cannot meet our obligations. This depends on the type of business and the circumstances of the claim.

Insurance advising and arranging is covered for 100% of the first £2,000 and 90% of the remainder of the claim, without any upper limit.

Further information about compensation scheme arrangements is available from the FSCS.

I have read, understood and accepted the key facts detailed above *

Download Chase Templeton Terms of Business Key Facts Download Chase Templeton Terms of Business Terms of Business To view the PDF files, download Adobe Reader