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
Are you a Sales Agent?
Agent Name
Agent Email
Customer Reference
Reason For Refund
Refund Amount (£)
Please enter a value with two decimal places.
Urgency of Refund
Name of Policy Holder
Refund Method:
Sort Code & Bank Details
Other Screenshots (Optional)
Is this refund request following a policy cancellation?