Refund Request
Please provide as much detail as possible. You will be notified via email with updates to your refund request.
UPDATE:
You
DO NOT
need to use this form if you have used the cancellation calculator, this ticket will be automatically generated. You
DO
need to use use it for everything else
Understood
Are you a Sales Agent?
Yes
No
This form has moved to Altissima 🤖
Please search/recall the policy by reference and then click on the blue icon with an arrow in to open the forms, located next to the notes icon, on the search results page.
If you have any questions, please ask your manager.
Please
do not continue here,
it will not be actioned.
Agent Name
Agent Email
Customer Reference
Reason For Refund
Refund Amount
Please enter a £ value with two decimal places.
Urgency of Refund
Medium
Low
Name of Policy Holder
Please provide full name.
Refund Method:
Card on File
Bank Transfer
Card & Bank Transfer
Screenshot from CPF
Sort Code & Bank Details
Drag and drop or browse files to upload
Other Screenshots (Optional)
Drag and drop or browse files to upload
Is this refund request following a policy cancellation?
Yes
No
Submit Form
Submit Form