Online Insurance for Kiwis

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Please ensure that you have completed your quote as information from it is transferred into this application form.

If you wish to apply for any of the insurance benefits,

You can download this PDF file and print it, complete the form, sign it and post it to us, or if you live in the Auckland area call 0800 269543 for an adviser to visit and assist complete an Application, or
alternatively you can call us on 0800 269543 and we will initiate an application and send it to you for checking, completion and signature(s) with a Return Stamp Addressed Envelope.

Post documents to FreePost 207963, NZMedical, P O Box 34778, Birkenhead, Auckland 0746

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