Get Data Capture Form

This guide provides you with comprehensive instructions on filling out the Data Capture Form online. By following the steps outlined below, you will ensure that your information is accurately captured for processing.

Follow the steps to effectively complete the Data Capture Form.

1. Press the 'Get Form' button to acquire the Data Capture Form and open it in your preferred online editor.
2. Begin with Section 1 'Person(s) to be Covered'. Here, you will need to provide details for the first person, including their title (Mr, Mrs, Ms), first name, surname, gender, date of birth, marital status, annual earned income, and consent to seek information from other insurers. Ensure all information is accurate and complete.
3. If applicable, fill out Section 2 'Policy Owner(s)'. This section is only for individuals who are different from the persons to be covered. Input the owner's title, name, gender, date of birth, marital status, address, and contact details.
4. Proceed to Section 3 'Contract Details'. Here, select your preferred policy start date, reason for coverage, and indicate whether the application is meant to be under trust or if it replaces an existing New Ireland policy.
5. Complete Sections 4-6, which include 'Cover Details' specific to the type of policy selected (Life Choice - Home, You and Family, or Assets). Carefully select the benefits and terms of coverage required based on your situation.
6. Section 7 collects 'Doctor/Clinic Details'. You will need to indicate if you have a doctor, and if so, provide their name, address, and phone number.
7. In Section 8, specify your 'Application Method'. You will have the option to select online, teleinterview, or both. Follow the instructions to complete this section based on your selected method.
8. Fill out Sections 9-11 for 'Personal Details', 'Occupation Information', and 'Risk Assessment'. These sections require you to provide detailed information about your health, occupation, and any medical history, so take your time to ensure all responses are thorough and accurate.
9. Finally, review the entire form for accuracy. Once you are satisfied, you can save changes, and download, print, or share the form as needed for submission.

Complete your Data Capture Form online now for a smooth submission process.