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All Med Pro
Quotes for Dental & Medical Insurance
0203 757 6950
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Home
Insurance type
Dentistry
Dental Indemnity
Dental Practice Insurance
Cyber Liability Insurance
Practice Overheads
Group Private Medical Insurance
Hands & Eyes
Pressure vessel inspection
Vets
Practice Insurance
Cyber Liability Insurance
Practice Overheads
Hands & Eyes
Pressure vessel inspection
Life Sciences
Medical Products
Vitamins/Supplements
Medical Tech/Wearables
Dental Laboratories
and Products
Private Hospital
Cyber Liability
Pressure vessel inspection
Commercial
Pressure vessel inspection
IT and Technology
Property Owners
Personal
Car
Property Owners
Home Contents
& Buildings Insurance
Surgeons
About AMP
Why AMP
Our Story
Our Team
Careers
Partners
OUR SUSTAINABLE VISION
Client area
Claims
Online Payment
My Account
Refer a Friend
News
Education
Events
Past webinars
podcasts
Contact
Home
Insurance type
Dentistry
Dental Indemnity
Dental Practice Insurance
Cyber Liability Insurance
Practice Overheads
Group Private Medical Insurance
Hands & Eyes
Pressure vessel inspection
Vets
Practice Insurance
Cyber Liability Insurance
Practice Overheads
Hands & Eyes
Pressure vessel inspection
Life Sciences
Medical Products
Vitamins/Supplements
Medical Tech/Wearables
Dental Laboratories
and Products
Private Hospital
Cyber Liability
Pressure vessel inspection
Commercial
Pressure vessel inspection
IT and Technology
Property Owners
Personal
Car
Property Owners
Home Contents
& Buildings Insurance
Surgeons
About AMP
Why AMP
Our Story
Our Team
Careers
Partners
OUR SUSTAINABLE VISION
Client area
Claims
Online Payment
My Account
Refer a Friend
News
Education
Events
Past webinars
podcasts
Contact
Step
1
of
2
50%
Referral Information
Name
*
First
Surname
is this New Business or Renewal to All Med Pro?
*
New Business
Renewal
MTA
Reason for referral
*
Select All
Practice Activities
Claims/Incidents
Policy Coverage
Age/Retirement
Other
Retroactive Date
*
DD dot MM dot YYYY
Proposal
*
Max. file size: 64 MB.
Please upload proposal
LOGS
Drop files here or
Select files
Max. file size: 64 MB.
Other supporting infomation
Drop files here or
Select files
Max. file size: 64 MB.
Please upload other supporting information such as CPD, Existing schedule, GDC hearing information etc/
Current Policy
Who is the current indemnity provider?
All Med Pro
Dental Protection
DDU
MDDUS
TDS
MMI4U
InSync
MIAB
MIC
Towergate
DIA
Servca
Euna
No previous cover
Other
Please provide indemnity providers name
Basis of cover
*
Claims Made
Claims Occurrence
Current limit of indemnity
Current excess
Current premium
Have the current indemnity providers applied any specific exclusions or terms?
*
Yes
No
Please eprovide details of exclusions and terms the current indemnity provider has applied.
Requested Cover
Limit of indemnity
Basis of cover
*
Claims Made
Claims Occurrence
Requested excess
Target premium
Additional notes
Referral Information
Practice Activities
Please provide full information on why the activity declared has been refered.
*
Claims/Incidents
Have you attached a clients summary of the claims/incidents?
*
Yes
No
List
Claim Date
Information
Have you attached a summary or supporting information on what steps the individual has taken to avoid these types of claim(s) and/or incident(s) in the future?
*
Yes
No
No information available
Please advise on what steps the client has taken to ensure these claim(s) and/or incident(s) will not happen again in the future
*
Please explain why this information has not been presented
*
Policy Coverage
Please provide further information on the reason for referral on cover
*
Age/Retirement
Please advise the reason for referral
*
Indvidual is over the age of 65 years of age
Individual is retiring in the next five years
Other
Individuals date of birth
*
DD slash MM slash YYYY
When date does the individual plan on retiring?
*
DD dot MM dot YYYY
Other - Please provide further information
*
Reason for referral - Other
Please advise
*
Account Handlers Details
Please select Handler
*
Adam Cackett
Adam O'Keeffe
David Baker
Jen Oakden-Howell
Jodie Bowes
Karen Coome
Simon Wyndow
Tom Chaston
Vicki Bennell-Phipps
Underwriter Details
Please select Underwriter
*
Adam Cackett
Adam O'Keeffe
Jodie Bowes
Tom Chaston
Any additional information
Name
This field is for validation purposes and should be left unchanged.
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