Medical Conditions

I am under the age of 81 years old

If you are 80 years old or younger and need to complete a manual Pre-Existing medical form then please download it below.

Download Now

Once completed please either post or fax to the details below.

I am aged 81 years old or over

If you are 81 years old or over and need to complete a manual Pre-Existing medical form then please download it below.

Download Now

Once completed please either post or fax to the details below.

What should I do with it?

Please either post or fax your PE form to the address below:

1Cover NZ Ltd.
11B / 17 Albert Street
Auckland 1010
New Zealand

Mon-Fri: 8.30am-9pm Sat: 11am-6pm Sun: 12pm-6pm

Fax: 0800 877 822

This insurance is underwritten by Allianz New Zealand Limited (Allianz). Because we don't know your financial needs, we can't advise if this insurance will suit you. You should consider your needs and read the Policy Wording before making a decision to buy insurance, to download a copy of the Policy Wording click here.