Get Unum Select Income Protection Application Form

Filling out the Unum Select Income Protection Application Form online is a straightforward process that helps you secure your income protection coverage. This guide provides detailed instructions to assist you in completing each section of the form accurately.

Follow the steps to complete the application form successfully.

1. Click the ‘Get Form’ button to retrieve the application form and open it in the online editor.
2. Begin by filling out the Employer Name and Employer Reference Number (RBCN) as applicable.
3. Select your Application Type by ticking the relevant box for Newly Eligible Member, Late Entrant, Change to existing Coverage, or Rehire.
4. Provide your Member Details, including your Employee Name, National Insurance Number, Gender, Date of Hire, Date of Birth, Occupation, Class, Annual Salary, Email Address, and Work Telephone Number.
5. Indicate whether you are Actively at Work by selecting 'Yes' or 'No.'
6. Specify your Scheduled Number of Working Hours per week.
7. Answer the question regarding tobacco use in the last 12 months by selecting 'Yes' or 'No.'
8. Proceed to the Benefit and Cost section, where benefits will be filled out by your enroller. Make sure you confirm the Benefit Amount, Payroll Frequency, and Cost.
9. In the Fitness and Lifestyle Details section, answer the questions about your height, current weight, and any absences from work due to sickness or injury.
10. Respond to the remaining questions relating to your health conditions, prior medical issues, and current symptoms as applicable.
11. Carefully review the Member Declaration section that outlines how your information will be processed, ensuring you understand your rights and responsibilities.
12. Sign the application, including your date of signature and full name to confirm your declarations and consent.
13. Once you have completed the form, you can save your changes, download the document, print it, or share it as necessary.

Take the next step towards securing your income protection by completing the Unum Select Income Protection Application Form online today.