life.staging.money.co.uk
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151.101.66.132
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https://life.staging.money.co.uk/
Submission: On July 27 via automatic, source certstream-suspicious — Scanned from DE
Submission: On July 27 via automatic, source certstream-suspicious — Scanned from DE
Form analysis 1 forms found in the DOM
POST /Quote
<form action="/Quote" class="lbl-left align-r clearfix full-page qp-trigger-save" id="Quote" method="post" novalidate="novalidate"><input class="input-validation-error" id="URN" name="URN" type="hidden" value=""><input id="DURN" name="DURN"
type="hidden" value=""><input class="input-validation-error" id="FandFURN" name="FandFURN" type="hidden" value=""><input id="optionQuotePlus" name="optionQuotePlus" type="hidden" value="True"><input class="input-validation-error"
id="ReferralSource" name="ReferralSource" type="hidden" value="Money_ol"><input class="input-validation-error" id="SearchEngine" name="SearchEngine" type="hidden" value=""><input id="ClientID" name="ClientID" type="hidden"
value="76d2eac2-b18b-2eb4-2024-051d8d31f5ef"><input id="RemoteAddress" name="RemoteAddress" type="hidden" value=""><input id="Reviewable" name="Reviewable" type="hidden" value=""><input id="WaiverPeriod" name="WaiverPeriod" type="hidden"
value=""><input id="ServerName" name="ServerName" type="hidden" value="CH-WEB02"><input id="QuotePlusApplicationId" name="QuotePlusApplicationId" type="hidden" value="-1"><input id="ExplicitConsent" name="ExplicitConsent" type="hidden"
value=""><input data-val="true" data-val-required="The Boolean field is required." id="useQuotePlus" name="useQuotePlus" type="hidden" value="False">
<fieldset class="box-blue about-quote-plus">
<div class="quote-options">
</div>
</fieldset>
<input id="gclid_field" name="gclid_field" type="hidden" value="">
<div id="polling-prep" class="polling display-none">
<header class="page-header page-header--full-width">
<div class="page-header__logo"><img src="/images/money/logo.svg" alt="Confused.com homepage"></div>
</header>
<div class="polling__main">
<div class="polling__main__copy">
<p>We are searching for your <b>life insurance quotes</b></p>
</div>
<div class="polling__main__content">
<div class="progress-bar">
<div class="progress-bar__progress progress-bar__progress--end"></div>
<div class="progress-bar__text"><span id="resultsReurned">Contacting providers...</span></div>
</div>
</div>
</div>
</div>
<input data-val="true" data-val-required="The gaSessionId field is required." id="gaSessionId" name="gaSessionId" type="hidden" value="794953225.1722047336-1722047336">
<input data-val="true" data-val-required="The UniqueCustomerCookieID field is required." id="UniqueCustomerCookieID" name="UniqueCustomerCookieID" type="hidden" value="">
<input data-val="true" data-val-required="The UniqueCustomerSessionID field is required." id="UniqueCustomerSessionID" name="UniqueCustomerSessionID" type="hidden" value="">
<div class="dimmer display-none" id="polling-prep-dimmer" onclick=" {$('.slide-out').addClass('slide-out--closed');$(this).addClass('display-none');}"></div>
<div class="note">
<p><b>It's important to answer questions truthfully, accurately and completely.</b> If you don't, your policy could end up being amended, cancelled, or a claim not being paid.</p>
</div>
<h2 class="section-heading section-heading--no-border"><a id="vnvf">Your policy details</a></h2>
<div id="error-box" class="error-summary" style="display:none">
<h3 id="error-box-message" class="error-summary__heading">
<span id="errorMessagePrefix">There are </span><span id="errorCount"></span><span id="errorMessageSuffix"> errors on this page that require your attention</span>
</h3>
<p>
<a id="error-box-link" class="error-summary__link">Skip to errors</a>
</p>
</div>
<fieldset class="bordered-section field-group">
<div class="field-group">
<label class="label--standard"><span>What do you need the insurance to protect?</span></label>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="xx-tooltip-trigger" type="checkbox">
<label id="ht_covertype" for="xx-tooltip-trigger"><span>More on each cover type</span></label>
<div id="xx-tooltip" role="tooltip">
<p><span class="policy-type title">Mortgage insurance </span>pays a sum of money that can be used to repay a mortgage or loan if you die during the term of the policy.</p>
<p><span class="policy-type title">Living costs insurance </span>pays a guaranteed and fixed sum of money if you die during the term of the policy which can be used to provide for living expenses or any other purposes.</p>
<p><span class="policy-type title">Mortgage and living costs insurance </span>pays a guaranteed and fixed sum of money if you die during the term of the policy. It can be used to repay a mortgage or loan and any other purposes,
including future living expenses.</p>
</div>
</div>
<input id="PolicyType" name="PolicyType" type="hidden" value="">
<input id="ProtectionType" name="ProtectionType" type="hidden" value="">
<input id="CurrentApplicantNumber" name="CurrentApplicantNumber" type="hidden" value="0">
<input id="CurrentSectionId" name="CurrentSectionId" type="hidden" value="0">
<span id="error-PolicyType" style="display:none" class="field-validation-error max-width">Select insurance type</span>
<div class="input-shell input-shell--option">
<input type="radio" id="ProtectionType-1" value="1" name="ProtectionType">
<label id="covertypemortgage" for="ProtectionType-1">Mortgage</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="ProtectionType-2" value="2" name="ProtectionType">
<label id="covertypelivingcosts" for="ProtectionType-2">Living costs</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="ProtectionType-3" value="3" name="ProtectionType">
<label id="covertypemortgagelivingcosts" for="ProtectionType-3">Mortgage and living costs</label>
</div>
</div>
<div class="field-group field-group--indented mortgagetype" style="display: none;">
<label class="label--standard"><span>What type of mortgage do you have?</span></label>
<input id="MortgageType" name="MortgageType" type="hidden" value="">
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="mortgagetype-tooltip-trigger" type="checkbox">
<label for="mortgagetype-tooltip-trigger"><span>Mortgage types explained</span></label>
<div id="mortgagetype-tooltip" role="tooltip">
<p><span class="policy-type title">A capital repayment or 'decreasing' mortgage </span>is where you pay off part of the mortage each month. The life insurance suited to this type of mortage would also reduce over the policy length. So
as more of the mortgage is paid off, the less the policy would pay out if you were to die during the mortgage term. If this isn't the type of policy you need you can change on the results page.</p>
<p><span class="policy-type title">An interest-only or 'level' mortgage </span>is when you only pay off the interest per month, so you'll still owe the full mortgage amount at the end of the term. The life cover suited for this is
called level cover. Both the cover and premiums are fixed or 'level' from the date you start paying the until the end of the policy term. So if you die during the term, the full policy amount will be paid out.</p>
</div>
</div>
<span id="MortgageType" style="display:none" class="field-validation-error">Mortgage Type is required</span>
<div class="input-shell input-shell--option">
<input type="radio" id="MortgageType-1" value="M" name="MortgageType">
<label id="mortgagetyperepayment" for="MortgageType-1" class="">Repayment (decreasing)</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="MortgageType-2" value="L" name="MortgageType">
<label id="mortgagetypeinterestonly" for="MortgageType-2">Interest only (level)</label>
</div>
</div>
<div class="field-group livingcostoptions" style="display: none;">
<label class="label--standard">Select a payout option for your living costs</label>
<div role="tooltip">You can always change your payout option on the quote result page.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="annualorlump-tooltip-trigger" type="checkbox">
<label id="ht_livingcosts" for="annualorlump-tooltip-trigger"><span>Living costs payout options explained</span></label>
<div id="annualorlump-tooltip" role="tooltip">
<p><span class="policy-type title">Annual income </span>is a family income benefit that covers your loved ones for the policy term. Once the term ends, the cover or any income payments stop.</p>
<p>For example, if you have a 20 year policy and die 5 years into it, the policy will pay out a regular income for the remaining 15 years. If you die nearer the end of the policy term, the total payout will be less than if you died earlier
in the term.</p>
<p><span class="policy-type title">Lump sum </span>is a level term life insurance where the amount paid out if you die is fixed. If you died within the term of the policy, you'd get the full amount quoted.</p>
<p>For example, a 20 year lump sum policy with a pay out of £150,000 would pay out this amount if you died during policy, no matter how far or short in to it. It provides certainty as both the cover and premiums are fixed from the date you
start paying until the end of the policy term.</p>
</div>
</div>
<span id="livingcostpayout-error" style="display: none" class="field-validation-error">Select payout option</span>
<div class="input-shell input-shell--option">
<input type="radio" id="livingcostpayout-1" value="K" name="livingcostpayout" class="replaced-input">
<label id="livingcostsannual" for="livingcostpayout-1" class="replaced-input-label replaced-input-label--radio">Annual Income</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="livingcostpayout-2" value="L" name="livingcostpayout" class="replaced-input" checked="checked">
<label id="livingcostslumpsum" for="livingcostpayout-2" class="replaced-input-label replaced-input-label--radio replaced-input-label--selected">Lump Sum</label>
</div>
</div>
<div id="sumassured-option-question" class="field-group">
<label class="label--standard hide-for-living-cost" for="SumAssured">How much cover do you need?</label>
<div id="SumAssured-SubText" role="tooltip">Think about how much your family or dependants would still need were you to die.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="sumassured-tooltip-trigger" type="checkbox">
<label id="ht_sumassured" for="sumassured-tooltip-trigger"><span>More details</span></label>
<div id="sumassured-tooltip" role="tooltip">
<p>Things to think about when working out how much money to leave to your family or dependants are:</p>
<p>
</p>
<ul>
<li>other financial commitments such as loans, overdrafts and credit cards</li>
<li>education costs</li>
<li>home living costs like bills, food, maintenance, home improvements</li>
<li>any sum you may want to leave your loved ones in the future</li>
</ul>
<p></p>
</div>
</div>
<span id="SumAssured-1" style="display: none" class="field-validation-error">Enter a value between £5,000 and £9,999,999</span>
<span id="SumAssured-2" style="display: none" class="field-validation-error">Enter amount of cover needed</span>
<span id="SumAssured-3" style="display: none" class="field-validation-error">The field Amount of cover must be a number.</span>
<span id="SumAssured-5" style="display: none" class="field-validation-error">Maximum value £100,000</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width" id="SumAssured" maxlength="11" name="SumAssured" oninput="this.value=this.value.slice(0,this.maxLength)" type="text" value="0">
</div>
</div>
<div class="slide-out-trigger-wrap">
<a class="slide-out-trigger" href="#" id="coverCalculatorSlideTrigger">
<span>Cover calculator</span>
</a>
</div>
<script src="/js/lifeCoverCalculator.js" defer=""></script>
<meta http-equiv="Content-Type" content="text/html; charset=utf-8">
<style>
.life-cover-calculator-field-group {
margin-bottom: 12px !important;
}
#totalCoverRequiredFieldGroup {
margin-top: 24px;
margin-bottom: 24px;
}
.label--small {
margin-bottom: 8px !important;
}
.life-cover-calculator-field-group>.input-shell--tooltip>div>p {
margin-bottom: 0px !important;
}
.life-cover-calculator-field-group>.input-shell--tooltip>label {
margin-top: 0.5rem !important;
margin-bottom: 0.5rem !important;
}
</style>
<div class="slide-out slide-out--closed" id="coverCalculatorSlideOut">
<div class="field-group life-cover-calculator-field-group">
<a class="slide-out__close slide-out--tabbable" href="#" id="coverCalculatorClose" tabindex="-1"><span>Close</span></a>
<label class="label--standard">Cover calculator</label>
</div>
<div id="lifeCoverCalculator">
<div class="field-group life-cover-calculator-field-group" id="mortgageOutstangingFieldGroup">
<label class="label--small" for="mortgageAmount">How much of your mortgage is still outstanding?</label>
<span class="field-validation-error display-none">Enter a value up to £9,999,999.</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width cover-subtotal slide-out--tabbable" id="mortgageAmount" type="text" value="" name="mortgageAmount" tabindex="-1">
</div>
</div>
<div class="field-group life-cover-calculator-field-group" id="anyOtherDebtsFieldGroup">
<label class="label--small" for="otherDebts">Do you have any other debts?</label>
<span class="field-validation-error display-none">Enter a value up to £9,999,999.</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width cover-subtotal slide-out--tabbable" id="otherDebts" type="text" value="" name="otherDebts" tabindex="-1">
</div>
</div>
<div class="field-group life-cover-calculator-field-group" id="futureExpenditureFieldGroup">
<label class="label--small" for="futureExpenditure">What future plans might your family need help with?</label>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger slide-out--tabbable" id="future-expenditure-tooltip-trigger" type="checkbox" tabindex="-1">
<label for="future-expenditure-tooltip-trigger"><span>More details</span></label>
<div id="future-expenditure-tooltip" role="tooltip">
<p>e.g. helping kids with Uni, your partner with a loan, etc.</p>
</div>
</div>
<span class="field-validation-error display-none">Enter a value up to £9,999,999.</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width cover-subtotal slide-out--tabbable" id="futureExpenditure" type="text" value="" name="futureExpenditure" tabindex="-1">
</div>
</div>
<div class="field-group life-cover-calculator-field-group" id="funeralCostsFieldGroup">
<label class="label--small" for="funeralCosts">Will your family need help with funeral costs?</label>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger slide-out--tabbable" id="funeral-costs-tooltip-trigger" type="checkbox" tabindex="-1">
<label for="funeral-costs-tooltip-trigger"><span>More details</span></label>
<div id="funeral-costs-tooltip" role="tooltip">
<p>The average cost of a UK funeral is £4,078 – SunLife Cost of Dying Report 2017</p>
</div>
</div>
<span class="field-validation-error display-none">Enter a value up to £9,999,999.</span>
<div class="input-shell input-shell--prefixed" style="width: fit-content;">
<input class="js-life-calc-field standard-width cover-subtotal slide-out--tabbable" id="funeralCosts" type="text" value="" name="funeralCosts" tabindex="-1">
</div>
</div>
<div class="field-group life-cover-calculator-field-group" id="otherFinancialRequirementsFieldGroup">
<label class="label--small" for="otherFinancialRequirements">Other financial requirements</label>
<span class="field-validation-error display-none">Enter a value up to £9,999,999.</span>
<div class="input-shell input-shell--prefixed" style="width: fit-content;">
<input class="js-life-calc-field standard-width cover-subtotal slide-out--tabbable" id="otherFinancialRequirements" type="text" value="" name="otherFinancialRequirements" tabindex="-1">
</div>
</div>
<div class="field-group" id="totalCoverRequiredFieldGroup">
<p><b>Total life cover value: £<span id="totalCoverRequired">0</span></b><span id="totalAmountValidationError" class="field-validation-error display-none">The total must be between £5,000 and £9,999,999.</span></p>
</div>
<div class="button-group">
<div class="button-group__item">
<a class="btn btn--secondary btn--small" id="useTotal">Use this total</a>
</div>
</div>
<div class="field-group">
<p>This is an illustration of the amount of life insurance you may need based on the information you've provided. It should not be taken as a recommendation or advice.</p>
</div>
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Quote_Term">How many years do you need your policy to last?</label>
<div role="tooltip">Consider things like when your mortgage comes to an end, and when your family and dependants would become self sufficient.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="term-tooltip-trigger" type="checkbox">
<label id="ht_term" for="term-tooltip-trigger"><span>Help with working out policy length</span></label>
<div id="term-tooltip" role="tooltip">
<label>Things to think about to help work out your policy length:</label>
<ul>
<li>If you only want cover for your mortgage, select how many years are left on your mortgage as your policy length</li>
<li>If you want to leave a lump sum as well as pay off your mortgage, think about who this money is going to and how much they'd need. As this is a financial safety net, consider how long your family or dependants would need to rely on
this money before becoming self sufficient</li>
<li>You can also choose to have life insurance for a fixed period or the rest of your life</li>
</ul>
</div>
</div>
<span id="Term-1" style="display:none" class="field-validation-error">Number of years must be between 5 and 40</span>
<span id="Term-2" style="display:none" class="field-validation-error">Enter how many years you want cover for</span>
<div class="input-shell input-shell--standard">
<input class="input-width medium" id="Term" maxlength="2" min="5" name="Term" oninput="this.value=this.value.slice(0,this.maxLength)" size="20" type="number" value="">
</div>
</div>
<div>
<label class="label--standard"><span>Who is the cover for?</span></label>
<input id="JointPolicy" name="JointPolicy" type="hidden" value="1">
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="jointpolicy-tooltip-trigger" type="checkbox">
<label id="ht_policytype" for="jointpolicy-tooltip-trigger"><span>Policy types explained</span></label>
<div id="jointpolicy-tooltip" role="tooltip">
<p><span class="policy-type title">A single life policy </span>insures just you.</p>
<p><span class="policy-type title">A joint life policy </span>insures you and someone else. You and the other insured life must have a shared financial interest. For example, joint financial commitments such as mortgages, children or
two friends with a joint mortgage. With a joint policy, if one of you die the cover is paid out but then the policy ends.</p>
<p>If there are two lives to insure, both of you could have a single policy. Two single policies may be more expensive than a joint policy, but it means that if one policy is claimed against, the other policy will remain active.</p>
</div>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="JointPolicy-1" value="1" name="JointPolicy" class="replaced-input justYou" checked="checked">
<label id="singlelife" for="JointPolicy-1">Just you</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="JointPolicy-2" value="2" name="JointPolicy" class="replaced-input jointPolicyYes youAndSomeone">
<label id="jointlife" for="JointPolicy-2">You and someone else</label>
</div>
</div>
</fieldset>
<div id="app1EditBox" class="panel" style="display: none;">
<div class="applicantEditText">
<strong>,</strong>
<input type="button" value="Edit" class="btn--transparent edit" id="btnApp1Edit">
</div>
</div>
<div id="app1Edit">
<input id="Applicant1_DoB" name="Applicant1.DoB" type="hidden" value="">
<input data-val="true" data-val-required="The URN field is required." id="Applicant1_URN" name="Applicant1.URN" type="hidden" value="">
<input data-val="true" data-val-required="The Applicant field is required." id="Applicant1_Applicant" name="Applicant1.Applicant" type="hidden" value="1">
<input id="Applicant1_Smoke" name="Applicant1.Smoke" type="hidden" value="">
<input data-val="true" data-val-required="The Sex field is required." id="Applicant1_Sex" name="Applicant1.Sex" type="hidden" value="">
<input data-val="true" data-val-required="The AppIsValid field is required." id="Applicant1_AppIsValid" name="Applicant1.AppIsValid" type="hidden" value="True">
<input data-val="true" data-val-required="The MinDDValue field is required." id="Applicant1_MinDDValue" name="Applicant1.MinDDValue" type="hidden" value="0">
<input data-val="true" data-val-required="The MaxDDValue field is required." id="Applicant1_MaxDDValue" name="Applicant1.MaxDDValue" type="hidden" value="0">
<input id="Applicant1_ExplicitConsent" name="Applicant1.ExplicitConsent" type="hidden" value="No">
<input data-val="true" data-val-required="The RequestedCallback field is required." id="Applicant1_RequestedCallback" name="Applicant1.RequestedCallback" type="hidden" value="">
<div class="bordered-section singlePolicySet hasqplus">
<h3 class="section-heading">About You (First Applicant)</h3>
<div class="field-group">
<input id="Applicant1_AppTitle" name="Applicant1.AppTitle" type="hidden" value="">
<label class="label--standard" for="Applicant1_AppTitle">Title</label>
<div role="tooltip">We recognise not all titles are included here and so may not represent you as it should.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="app1title-tooltip-trigger" type="checkbox">
<label for="app1title-tooltip-trigger"><span id="ht_1-title">Why isn't my title listed?</span></label>
<div id="app1title-tooltip" role="tooltip">
<p>For now these titles are what our system and insurance providers use. We're working to add in more inclusive titles.</p>
</div>
</div>
<span id="Applicant1.AppTitle" style="display: none;" class="field-validation-error">Select the policyholder's title</span>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_AppTitle-1" value="Mr" name="Applicant1.AppTitle" class="replaced-input">
<label id="title_1-mr" for="Applicant1_AppTitle-1">Mr</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_AppTitle-2" value="Mrs" name="Applicant1.AppTitle" class="replaced-input">
<label id="title_1-mrs" for="Applicant1_AppTitle-2" class="replaced-input-label replaced-input-label--radio">Mrs</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_AppTitle-3" value="Ms" name="Applicant1.AppTitle" class="replaced-input">
<label id="title_1-ms" for="Applicant1_AppTitle-3" class="replaced-input-label replaced-input-label--radio">Ms</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_AppTitle-4" value="Miss" name="Applicant1.AppTitle" class="replaced-input">
<label id="title_1-miss" for="Applicant1_AppTitle-4" class="replaced-input-label replaced-input-label--radio">Miss</label>
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Applicant1_Forename">First name</label>
<span id="Applicant1.Forename" style="display: none;" class="field-validation-error">Enter the policyholder's first name</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant1_Forename" maxlength="18" name="Applicant1.Forename" onkeypress="return /[a-zA-Z-_]/i.test(event.key)" size="20" type="text" value="">
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Applicant1_Surname">Surname</label>
<span id="Applicant1.Surname" style="display: none;" class="field-validation-error">Enter the policyholder's surname</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant1_Surname" maxlength="35" name="Applicant1.Surname" onkeypress="return /[a-zA-Z-_]/i.test(event.key)" size="20" type="text" value="">
</div>
</div>
<div class="field-group">
<label class="label--standard" id="dob"> <span>Date of birth</span></label>
<span id="Applicant1.DOBDD-2" style="display: none;" class="field-validation-error">Enter the birth day, month and year as numbers</span>
<span id="Applicant1.DOBDD-1" style="display: none;" class="field-validation-error">Please select a valid date of birth.</span>
<div class="date-field">
<label for="Applicant1_DOBDD">Day</label>
<div>
<input class="day-month" id="Applicant1_DOBDD" maxlength="2" name="Applicant1.DOBDD" placeholder="DD" type="text" value="">
</div>
</div>
<div class="date-field">
<label for="Applicant1_DOBMM">Month</label>
<div>
<input class="day-month" id="Applicant1_DOBMM" maxlength="2" name="Applicant1.DOBMM" placeholder="MM" type="text" value="">
</div>
</div>
<div class="date-field">
<label for="Applicant1_DOBYYYY">Year</label>
<div>
<input id="Applicant1_DOBYYYY" maxlength="4" name="Applicant1.DOBYYYY" placeholder="YYYY" type="text" value="">
</div>
</div>
</div>
<div class="field-group">
<div class="label--standard" for="Applicant1_PostCode">Postcode</div>
<span id="Applicant1.PostCode" style="display: none;" class="field-validation-error">Please enter a valid UK postcode</span>
<div class="input-shell input-shell--spaced">
<input class="half-width medium" id="Applicant1_PostCode" name="Applicant1.PostCode" size="20" type="text" value="" maxlength="10">
</div>
</div>
<div class="field-group">
<div class="field-group">
<label class="label--standard" for="Applicant1_Email">Email address</label>
<div role="tooltip">We'll send you a confirmation email with your insurance quotes.</div>
<span id="Applicant1.Email" style="display:none" class="field-validation-error">Please enter a valid email address.</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant1_Email" name="Applicant1.Email" size="30" type="email" value="">
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Applicant1_PhoneHome">Telephone number</label>
<div role="tooltip">Providing your phone number is optional but will allow us to contact you to assist with your life insurance quotation. Providing your phone number is consent for us to contact you to offer assistance.</div>
<span id="Applicant1.PhoneHome" style="display:none" class="field-validation-error">Please enter a valid phone number</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant1_PhoneHome" maxlength="16" name="Applicant1.PhoneHome" size="20" type="tel" value="">
</div>
</div>
</div>
<input data-val="true" data-val-required="The fadviserid field is required." id="Applicant1_fadviserid" name="Applicant1.fadviserid" type="hidden" value="">
<div class="field-group AppAnswers App1Answers">
<label class="label--standard">What's your height?</label>
<div role="tooltip">Select how you measure your height</div>
<span id="error-Applicant1.IsMetricHeight-radio" style="display: none;" class="field-validation-error">Select if you measure in centimetres or feet/inches</span>
<input id="Applicant1_IsMetricHeight" name="Applicant1.IsMetricHeight" type="hidden" value="">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsMetricHeight-1" value="1" name="Applicant1.IsMetricHeight" class="replaced-input">
<label id="heightcm_1" for="Applicant1_IsMetricHeight-1">Centimetres</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsMetricHeight-2" value="0" name="Applicant1.IsMetricHeight" class="replaced-input">
<label id="heightfeet_1" for="Applicant1_IsMetricHeight-2">Feet/inches</label>
</div>
</div>
<div class="field-group field-group--indented Applicant-1-heightsection AppAnswers App1Answers" style="display: none;">
<div role="tooltip">We need your height without shoes on</div>
<span id="Applicant1.HeightFeet-1" style="display: none;" class="field-validation-error">Enter a height between 91.44 - 210.82 cm. If you're shorter or taller, call 0800 422 0060 for further help</span>
<span id="Applicant1.HeightFeet-2" style="display: none;" class="field-validation-error">Enter a height between 3ft - 6ft 11. If you're shorter or taller, call 0800 422 0060 for further help</span>
<span id="Applicant1.HeightFeet-range-imperial" style="display: none;" class="field-validation-error">Allowable range 3ft - 6ft 11 inches. If outside of this range, please call 0800 422 0060.</span>
<span id="Applicant1.HeightFeet-range-metric" style="display: none;" class="field-validation-error">Allowable range 92cm - 211cm. If outside of this range, please call 0800 422 0060.</span>
<div id="Applicant-1-height-imperial" data-tooltip="height-1" class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label style="width: 45px;" for="Applicant1_HeightFeet">Feet</label>
<div>
<input class="OnlyNumbers number-input-width" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between 3 and 6" data-val-range-max="6" data-val-range-min="3"
data-val-required="You must answer this question." id="Applicant1_HeightFeet" max="6" maxlength="1" min="3" name="Applicant1.HeightFeet" oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1"
type="number" value="">
</div>
</div>
</div>
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label style="width: 45px;" for="Applicant1_HeightInches" class="">Inches</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between 0 and 11" data-val-range-max="11" data-val-range-min="0"
data-val-required="You must answer this question." id="Applicant1_HeightInches" max="11" maxlength="2" min="0" name="Applicant1.HeightInches" oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1"
type="number" value="">
</div>
</div>
</div>
</div>
<div id="Applicant-1-height-metric" class="date-field">
<label for="Applicant1_HeightCentimeters">Centimetres</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The HeightCentimeters field is required." id="Applicant1_HeightCentimeters" maxlength="3" name="Applicant1.HeightCentimeters"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" step="1" type="number" value="">
</div>
</div>
</div>
<div class="field-group AppAnswers App1Answers">
<label class="label--standard">What's your weight?</label>
<div role="tooltip">Select how you measure your weight</div>
<span id="error-Applicant1.IsMetricWeight-radio" style="display: none;" class="field-validation-error">Select if you measure in kilograms or stones/pounds</span>
<input id="Applicant1_IsMetricWeight" name="Applicant1.IsMetricWeight" type="hidden" value="">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsMetricWeight-1" value="1" name="Applicant1.IsMetricWeight" class="replaced-input">
<label id="weightkg_1" for="Applicant1_IsMetricWeight-1">Kilograms</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsMetricWeight-2" value="0" name="Applicant1.IsMetricWeight" class="replaced-input">
<label id="weightstone_1" for="Applicant1_IsMetricWeight-2">Stone/pounds</label>
</div>
</div>
<div class="field-group field-group--indented Applicant-1-weightsection AppAnswers App1Answers" style="display: none;">
<div role="tooltip">We need your weight to include wearing clothes</div>
<span id="Applicant1.WeightStone-1" style="display: none;" class="field-validation-error">Enter a weight between 31.75 - 153.23kg. If weight is outside this range, call 0800 422 0060 for further help</span>
<span id="Applicant1.WeightStone-2" style="display: none;" class="field-validation-error">Enter a weight between 5st - 24st 13lbs. If weight is outside this range, call 0800 422 0060 for further help</span>
<span id="Applicant1.WeightStone-range-imperial" style="display: none;" class="field-validation-error">Allowable range 5st - 24st 13lbs. If outside of this range, please call 0800 422 0060.</span>
<span id="Applicant1.WeightStone-range-metric" style="display: none;" class="field-validation-error">Allowable range 32kg - 158kg. If outside of this range, please call 0800 422 0060.</span>
<div id="Applicant-1-weight-imperial" data-at="qp_1-weight" class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label for="Applicant1_WeightStone">Stone</label>
<div>
<input class="OnlyNumbers number-input-width" data-val="true" data-val-required="The WeightStone field is required." id="Applicant1_WeightStone" max="24" maxlength="2" min="5" name="Applicant1.WeightStone"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1" type="number" value="">
</div>
</div>
</div>
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label for="Applicant1_WeightPounds" class="">Pounds</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The WeightPounds field is required." id="Applicant1_WeightPounds" max="13" maxlength="2" min="0" name="Applicant1.WeightPounds"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1" type="number" value="">
</div>
</div>
</div>
</div>
<div id="Applicant-1-weight-metric" class="date-field">
<label for="Applicant1_WeightKilograms">Kilograms</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The WeightKilograms field is required." id="Applicant1_WeightKilograms" maxlength="3" name="Applicant1.WeightKilograms" oninput="this.value=this.value.slice(0,this.maxLength)"
pattern="[0-9]*" step="1" type="number" value="">
</div>
</div>
</div>
</div>
<div class="field-group AppAnswers App1Answers singlePolicySet">
<h3 class="section-heading">Lifestyle</h3>
<div class="field-group smoking-status">
<input data-val="true" data-val-required="The SmokerStatus field is required." id="Applicant1_SmokerStatus" name="Applicant1.SmokerStatus" type="hidden" value="0">
<label class="label--standard">Do you smoke?</label>
<div role="tooltip">If you've smoked in the last 12 months you're classed as a 'current smoker'. This includes cigars, pipes, e-cigarettes, nicotine replacements and regular cigarettes.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="smoker-1-tooltip-trigger" type="checkbox">
<label for="smoker-1-tooltip-trigger"><span id="ht_1-smoker">How do you class smokers?</span></label>
<div id="smoker-1-tooltip" role="tooltip">
<p>Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes.</p>
</div>
</div>
<span class="label-style field-validation-error" id="err-SmokerStatus-1" style="display:none">Select if the policyholder has ever smoked</span>
<div data-at="qp_1-issmoker">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_SmokerStatus-2" value="2" name="Applicant1.SmokerStatus" class="replaced-input smokerNow">
<label id="smokercurrent_1" for="Applicant1_SmokerStatus-2" class="replaced-input-label replaced-input-label--radio">Yes - current smoker</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_SmokerStatus-3" value="3" name="Applicant1.SmokerStatus" class="replaced-input smokerEx">
<label id="smokerex_1" for="Applicant1_SmokerStatus-3" class="replaced-input-label replaced-input-label--radio">Yes - ex-smoker</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_SmokerStatus-1" value="1" name="Applicant1.SmokerStatus" class="replaced-input smokerNever">
<label id="smokernever_1" for="Applicant1_SmokerStatus-1" class="replaced-input-label replaced-input-label--radio">No - never smoked</label>
</div>
</div>
</div>
<div class="field-group field-group--indented ex-smoker" style="display: none;">
<div class="field-group past-smoker">
<span class="label--standard">When did you quit?</span>
<input data-val="true" data-val-required="The When did you quit? field is required." id="Applicant1_IsYearsSinceSmoked" name="Applicant1.IsYearsSinceSmoked" type="hidden" value="0">
<div role="tooltip">If you've quit within last 12 months or used a nicotine replacement within this timeframe you're classed as a smoker.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="exsmoker-1-tooltip-trigger" type="checkbox">
<label for="exsmoker-1-tooltip-trigger"><span>More details</span></label>
<div id="exsmoker-1-tooltip" role="tooltip">
<p>If you have smoked or used any tobacco products (including cigars, a pipe, cigarettes or nicotine replacement products) in the last 12 months then you are classified as a smoker.</p>
</div>
</div>
<div data-at="qp_1-smokinghistory" class="input-group">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsYearsSinceSmoked-1" value="0" name="Applicant1.IsYearsSinceSmoked" class="replaced-input lttma" checked="checked">
<label id="exsmokerless12_1" for="Applicant1_IsYearsSinceSmoked-1">Less than 12 months ago</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant1_IsYearsSinceSmoked-2" value="1" name="Applicant1.IsYearsSinceSmoked" class="replaced-input mttma">
<label id="exsmokermore12_1" for="Applicant1_IsYearsSinceSmoked-2" class="replaced-input-label replaced-input-label--radio">More than 12 months ago</label>
</div>
</div>
</div>
<div class="field-group field-group--indented smoke-amount" style="display: none;">
<label class="label--standard" for="Applicant1_DailySmokingAmount">On average, how many cigarettes or equivalent did you or do you smoke per day?</label>
<span id="err-SmokePerDay-1" class="field-validation-error" style="display: none;">Enter policyholder's average daily amount of cigarettes or equivalent</span>
<div class="date-field">
<label for="Applicant1_DailySmokingAmount">Per day</label>
<div>
<input class="number-input-width" data-qp-target-field="8" data-val-number="Please enter a number" id="Applicant1_DailySmokingAmount" max="99" maxlength="2" min="0" name="Applicant1.DailySmokingAmount"
oninput="this.value=this.value.slice(0,this.maxLength)" size="2" type="number" value="">
</div>
</div>
</div>
<div class="field-group field-group--indented yearsSinceSmoked" style="display: none;">
<label class="label--standard" for="Applicant1_YearsSinceSmoked">How many years ago did you quit smoking?</label>
<span id="err-YearsSinceSmoked-1" class="field-validation-error" style="display: none;">Enter how many years it's been since the policyholder quit smoking to the nearest year</span>
<span id="one-five-YearsSinceSmoked-1" class="field-validation-smoker" style="display: none;">Premium may increase if you have smoked in the last 1-5 years</span>
<div class="date-field">
<label for="Applicant1_YearsSinceSmoked">years</label>
<span class="field-validation-error" style="display: none;">This field cannot be blank</span>
<div>
<input class="number-input-width" data-val-number="Please enter a number" id="Applicant1_YearsSinceSmoked" max="99" maxlength="2" min="0" name="Applicant1.YearsSinceSmoked" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
</div>
</div>
<fieldset class="bordered-section AppAnswers App1Answers singlePolicySet section-1 hasqplus section_open" id="Section_199_App1" iscomplete="False" style="">
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_0__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-gender" class="AppAnswers App1Answers Answer1 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_0__ApplicantAnswerID" name="Applicant1.QuestionSet[0].ApplicantAnswerID" type="hidden" value="3269364">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_0__ApplicantId" name="Applicant1.QuestionSet[0].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_0__ApplicationId" name="Applicant1.QuestionSet[0].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_0__QuestionID" name="Applicant1.QuestionSet[0].QuestionID" type="hidden" value="1">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_0__ApplicantNumber" name="Applicant1.QuestionSet[0].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_0__SectionId" name="Applicant1.QuestionSet[0].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[0].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_0__AnswerValue" name="Applicant1.QuestionSet[0].AnswerValue" type="hidden" value="1">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_1__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-age" class="AppAnswers App1Answers Answer2 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_1__ApplicantAnswerID" name="Applicant1.QuestionSet[1].ApplicantAnswerID" type="hidden" value="3269365">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_1__ApplicantId" name="Applicant1.QuestionSet[1].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_1__ApplicationId" name="Applicant1.QuestionSet[1].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_1__QuestionID" name="Applicant1.QuestionSet[1].QuestionID" type="hidden" value="2">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_1__ApplicantNumber" name="Applicant1.QuestionSet[1].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_1__SectionId" name="Applicant1.QuestionSet[1].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[1].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_1__AnswerValue" name="Applicant1.QuestionSet[1].AnswerValue" type="hidden" value="0">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_2__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-sumassured" class="AppAnswers App1Answers Answer3 input-group">
<input id="Applicant1_QuestionSet_2__QuestionText" name="Applicant1.QuestionSet[2].QuestionText" type="hidden" value="SumAssured">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_2__ApplicantAnswerID" name="Applicant1.QuestionSet[2].ApplicantAnswerID" type="hidden" value="3269366">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_2__ApplicantId" name="Applicant1.QuestionSet[2].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_2__ApplicationId" name="Applicant1.QuestionSet[2].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_2__QuestionID" name="Applicant1.QuestionSet[2].QuestionID" type="hidden" value="3">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_2__ApplicantNumber" name="Applicant1.QuestionSet[2].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_2__SectionId" name="Applicant1.QuestionSet[2].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[2].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_2__AnswerValue" name="Applicant1.QuestionSet[2].AnswerValue" type="hidden" value="100000">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_3__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-term" class="AppAnswers App1Answers Answer4 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_3__ApplicantAnswerID" name="Applicant1.QuestionSet[3].ApplicantAnswerID" type="hidden" value="3269367">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_3__ApplicantId" name="Applicant1.QuestionSet[3].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_3__ApplicationId" name="Applicant1.QuestionSet[3].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_3__QuestionID" name="Applicant1.QuestionSet[3].QuestionID" type="hidden" value="4">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_3__ApplicantNumber" name="Applicant1.QuestionSet[3].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_3__SectionId" name="Applicant1.QuestionSet[3].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[3].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_3__AnswerValue" name="Applicant1.QuestionSet[3].AnswerValue" type="hidden" value="20">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_4__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_issmoker-App1" class="AppAnswers App1Answers Answer11 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_4__ApplicantAnswerID" name="Applicant1.QuestionSet[4].ApplicantAnswerID" type="hidden" value="3269373">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_4__ApplicantId" name="Applicant1.QuestionSet[4].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_4__ApplicationId" name="Applicant1.QuestionSet[4].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_4__QuestionID" name="Applicant1.QuestionSet[4].QuestionID" type="hidden" value="11">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_4__ApplicantNumber" name="Applicant1.QuestionSet[4].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_4__SectionId" name="Applicant1.QuestionSet[4].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[4].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_4__AnswerValue" name="Applicant1.QuestionSet[4].AnswerValue" type="hidden" value="0">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_5__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-bmi" class="AppAnswers App1Answers Answer5 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_5__ApplicantAnswerID" name="Applicant1.QuestionSet[5].ApplicantAnswerID" type="hidden" value="3269368">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_5__ApplicantId" name="Applicant1.QuestionSet[5].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_5__ApplicationId" name="Applicant1.QuestionSet[5].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_5__QuestionID" name="Applicant1.QuestionSet[5].QuestionID" type="hidden" value="5">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_5__ApplicantNumber" name="Applicant1.QuestionSet[5].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_5__SectionId" name="Applicant1.QuestionSet[5].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[5].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_5__AnswerValue" name="Applicant1.QuestionSet[5].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant1_QuestionSet_6__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_height-App1" class="AppAnswers App1Answers Answer6 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_6__ApplicantAnswerID" name="Applicant1.QuestionSet[6].ApplicantAnswerID" type="hidden" value="3269369">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_6__ApplicantId" name="Applicant1.QuestionSet[6].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_6__ApplicationId" name="Applicant1.QuestionSet[6].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_6__QuestionID" name="Applicant1.QuestionSet[6].QuestionID" type="hidden" value="6">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_6__ApplicantNumber" name="Applicant1.QuestionSet[6].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_6__SectionId" name="Applicant1.QuestionSet[6].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App1Answers Answer6 qp_height" data-val="true" data-val-required="You must answer this question." id="Applicant1_QuestionSet_6__AnswerValue" name="Applicant1.QuestionSet[6].AnswerValue"
title="Please enter your height (without shoes)">
<option value="91.44">3ft 0ins</option>
<option value="93.98">3ft 1ins</option>
<option value="96.52">3ft 2ins</option>
<option value="99.06">3ft 3ins</option>
<option value="101.6">3ft 4ins</option>
<option value="104.14">3ft 5ins</option>
<option value="106.68">3ft 6ins</option>
<option value="109.22">3ft 7ins</option>
<option value="111.76">3ft 8ins</option>
<option value="114.3">3ft 9ins</option>
<option value="116.84">3ft 10ins</option>
<option value="119.38">3ft 11ins</option>
<option value="121.92">4ft 0ins</option>
<option value="124.46">4ft 1ins</option>
<option value="127">4ft 2ins</option>
<option value="129.54">4ft 3ins</option>
<option value="132.08">4ft 4ins</option>
<option value="134.62">4ft 5ins</option>
<option value="137.16">4ft 6ins</option>
<option value="139.7">4ft 7ins</option>
<option value="142.24">4ft 8ins</option>
<option value="144.78">4ft 9ins</option>
<option value="147.32">4ft 10ins</option>
<option value="149.86">4ft 11ins</option>
<option value="152.4">5ft 0ins</option>
<option value="154.94">5ft 1ins</option>
<option value="157.48">5ft 2ins</option>
<option value="160.02">5ft 3ins</option>
<option value="162.56">5ft 4ins</option>
<option value="165.1">5ft 5ins</option>
<option value="167.64">5ft 6ins</option>
<option value="170.18">5ft 7ins</option>
<option value="172.72">5ft 8ins</option>
<option value="175.26">5ft 9ins</option>
<option value="177.8">5ft 10ins</option>
<option value="180.34">5ft 11ins</option>
<option value="182.88">6ft 0ins</option>
<option value="185.42">6ft 1ins</option>
<option value="187.96">6ft 2ins</option>
<option value="190.5">6ft 3ins</option>
<option value="193.04">6ft 4ins</option>
<option value="195.58">6ft 5ins</option>
<option value="198.12">6ft 6ins</option>
<option value="200.66">6ft 7ins</option>
<option value="203.2">6ft 8ins</option>
<option value="205.74">6ft 9ins</option>
<option value="208.28">6ft 10ins</option>
<option value="210.82">6ft 11ins</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant1_QuestionSet_7__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_weight-App1" class="AppAnswers App1Answers Answer7 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_7__ApplicantAnswerID" name="Applicant1.QuestionSet[7].ApplicantAnswerID" type="hidden" value="3269370">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_7__ApplicantId" name="Applicant1.QuestionSet[7].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_7__ApplicationId" name="Applicant1.QuestionSet[7].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_7__QuestionID" name="Applicant1.QuestionSet[7].QuestionID" type="hidden" value="7">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_7__ApplicantNumber" name="Applicant1.QuestionSet[7].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_7__SectionId" name="Applicant1.QuestionSet[7].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App1Answers Answer7 qp_weight" data-val="true" data-val-required="You must answer this question." id="Applicant1_QuestionSet_7__AnswerValue" name="Applicant1.QuestionSet[7].AnswerValue"
title="Please enter your weight (wearing indoor clothes)">
<option value="31.75">5st 0lbs</option>
<option value="32.21">5st 1lbs</option>
<option value="32.66">5st 2lbs</option>
<option value="33.11">5st 3lbs</option>
<option value="33.57">5st 4lbs</option>
<option value="34.02">5st 5lbs</option>
<option value="34.47">5st 6lbs</option>
<option value="34.93">5st 7lbs</option>
<option value="35.38">5st 8lbs</option>
<option value="35.83">5st 9lbs</option>
<option value="36.29">5st 10lbs</option>
<option value="36.74">5st 11lbs</option>
<option value="37.19">5st 12lbs</option>
<option value="37.65">5st 13lbs</option>
<option value="38.10">6st 0lbs</option>
<option value="38.56">6st 1lbs</option>
<option value="39.01">6st 2lbs</option>
<option value="39.46">6st 3lbs</option>
<option value="39.92">6st 4lbs</option>
<option value="40.37">6st 5lbs</option>
<option value="40.82">6st 6lbs</option>
<option value="41.28">6st 7lbs</option>
<option value="41.73">6st 8lbs</option>
<option value="42.18">6st 9lbs</option>
<option value="42.64">6st 10lbs</option>
<option value="43.09">6st 11lbs</option>
<option value="43.54">6st 12lbs</option>
<option value="44.00">6st 13lbs</option>
<option value="44.45">7st 0lbs</option>
<option value="44.91">7st 1lbs</option>
<option value="45.36">7st 2lbs</option>
<option value="45.81">7st 3lbs</option>
<option value="46.27">7st 4lbs</option>
<option value="46.72">7st 5lbs</option>
<option value="47.17">7st 6lbs</option>
<option value="47.63">7st 7lbs</option>
<option value="48.08">7st 8lbs</option>
<option value="48.53">7st 9lbs</option>
<option value="48.99">7st 10lbs</option>
<option value="49.44">7st 11lbs</option>
<option value="49.90">7st 12lbs</option>
<option value="50.35">7st 13lbs</option>
<option value="50.80">8st 0lbs</option>
<option value="51.26">8st 1lbs</option>
<option value="51.71">8st 2lbs</option>
<option value="52.16">8st 3lbs</option>
<option value="52.62">8st 4lbs</option>
<option value="53.07">8st 5lbs</option>
<option value="53.52">8st 6lbs</option>
<option value="53.98">8st 7lbs</option>
<option value="54.43">8st 8lbs</option>
<option value="54.88">8st 9lbs</option>
<option value="55.34">8st 10lbs</option>
<option value="55.79">8st 11lbs</option>
<option value="56.25">8st 12lbs</option>
<option value="56.70">8st 13lbs</option>
<option value="57.15">9st 0lbs</option>
<option value="57.61">9st 1lbs</option>
<option value="58.06">9st 2lbs</option>
<option value="58.51">9st 3lbs</option>
<option value="58.97">9st 4lbs</option>
<option value="59.42">9st 5lbs</option>
<option value="59.87">9st 6lbs</option>
<option value="60.33">9st 7lbs</option>
<option value="60.78">9st 8lbs</option>
<option value="61.23">9st 9lbs</option>
<option value="61.69">9st 10lbs</option>
<option value="62.14">9st 11lbs</option>
<option value="62.60">9st 12lbs</option>
<option value="63.05">9st 13lbs</option>
<option value="63.50">10st 0lbs</option>
<option value="63.96">10st 1lbs</option>
<option value="64.41">10st 2lbs</option>
<option value="64.86">10st 3lbs</option>
<option value="65.32">10st 4lbs</option>
<option value="65.77">10st 5lbs</option>
<option value="66.22">10st 6lbs</option>
<option value="66.68">10st 7lbs</option>
<option value="67.13">10st 8lbs</option>
<option value="67.59">10st 9lbs</option>
<option value="68.04">10st 10lbs</option>
<option value="68.49">10st 11lbs</option>
<option value="68.95">10st 12lbs</option>
<option value="69.40">10st 13lbs</option>
<option value="69.85">11st 0lbs</option>
<option value="70.31">11st 1lbs</option>
<option value="70.76">11st 2lbs</option>
<option value="71.21">11st 3lbs</option>
<option value="71.67">11st 4lbs</option>
<option value="72.12">11st 5lbs</option>
<option value="72.57">11st 6lbs</option>
<option value="73.03">11st 7lbs</option>
<option value="73.48">11st 8lbs</option>
<option value="73.94">11st 9lbs</option>
<option value="74.39">11st 10lbs</option>
<option value="74.84">11st 11lbs</option>
<option value="75.30">11st 12lbs</option>
<option value="75.75">11st 13lbs</option>
<option value="76.20">12st 0lbs</option>
<option value="76.66">12st 1lbs</option>
<option value="77.11">12st 2lbs</option>
<option value="77.56">12st 3lbs</option>
<option value="78.02">12st 4lbs</option>
<option value="78.47">12st 5lbs</option>
<option value="78.93">12st 6lbs</option>
<option value="79.38">12st 7lbs</option>
<option value="79.83">12st 8lbs</option>
<option value="80.29">12st 9lbs</option>
<option value="80.74">12st 10lbs</option>
<option value="81.19">12st 11lbs</option>
<option value="81.65">12st 12lbs</option>
<option value="82.10">12st 13lbs</option>
<option value="82.55">13st 0lbs</option>
<option value="83.01">13st 1lbs</option>
<option value="83.46">13st 2lbs</option>
<option value="83.91">13st 3lbs</option>
<option value="84.37">13st 4lbs</option>
<option value="84.82">13st 5lbs</option>
<option value="85.28">13st 6lbs</option>
<option value="85.73">13st 7lbs</option>
<option value="86.18">13st 8lbs</option>
<option value="86.64">13st 9lbs</option>
<option value="87.09">13st 10lbs</option>
<option value="87.54">13st 11lbs</option>
<option value="88.00">13st 12lbs</option>
<option value="88.45">13st 13lbs</option>
<option value="88.90">14st 0lbs</option>
<option value="89.36">14st 1lbs</option>
<option value="89.81">14st 2lbs</option>
<option value="90.26">14st 3lbs</option>
<option value="90.72">14st 4lbs</option>
<option value="91.17">14st 5lbs</option>
<option value="91.63">14st 6lbs</option>
<option value="92.08">14st 7lbs</option>
<option value="92.53">14st 8lbs</option>
<option value="92.99">14st 9lbs</option>
<option value="93.44">14st 10lbs</option>
<option value="93.89">14st 11lbs</option>
<option value="94.35">14st 12lbs</option>
<option value="94.80">14st 13lbs</option>
<option value="95.25">15st 0lbs</option>
<option value="95.71">15st 1lbs</option>
<option value="96.16">15st 2lbs</option>
<option value="96.62">15st 3lbs</option>
<option value="97.07">15st 4lbs</option>
<option value="97.52">15st 5lbs</option>
<option value="97.98">15st 6lbs</option>
<option value="98.43">15st 7lbs</option>
<option value="98.88">15st 8lbs</option>
<option value="99.34">15st 9lbs</option>
<option value="99.79">15st 10lbs</option>
<option value="100.24">15st 11lbs</option>
<option value="100.70">15st 12lbs</option>
<option value="101.15">15st 13lbs</option>
<option value="101.60">16st 0lbs</option>
<option value="102.06">16st 1lbs</option>
<option value="102.51">16st 2lbs</option>
<option value="102.97">16st 3lbs</option>
<option value="103.42">16st 4lbs</option>
<option value="103.87">16st 5lbs</option>
<option value="104.33">16st 6lbs</option>
<option value="104.78">16st 7lbs</option>
<option value="105.23">16st 8lbs</option>
<option value="105.69">16st 9lbs</option>
<option value="106.14">16st 10lbs</option>
<option value="106.59">16st 11lbs</option>
<option value="107.05">16st 12lbs</option>
<option value="107.50">16st 13lbs</option>
<option value="107.95">17st 0lbs</option>
<option value="108.41">17st 1lbs</option>
<option value="108.86">17st 2lbs</option>
<option value="109.32">17st 3lbs</option>
<option value="109.77">17st 4lbs</option>
<option value="110.22">17st 5lbs</option>
<option value="110.68">17st 6lbs</option>
<option value="111.13">17st 7lbs</option>
<option value="111.58">17st 8lbs</option>
<option value="112.04">17st 9lbs</option>
<option value="112.49">17st 10lbs</option>
<option value="112.94">17st 11lbs</option>
<option value="113.40">17st 12lbs</option>
<option value="113.85">17st 13lbs</option>
<option value="114.31">18st 0lbs</option>
<option value="114.76">18st 1lbs</option>
<option value="115.21">18st 2lbs</option>
<option value="115.67">18st 3lbs</option>
<option value="116.12">18st 4lbs</option>
<option value="116.57">18st 5lbs</option>
<option value="117.03">18st 6lbs</option>
<option value="117.48">18st 7lbs</option>
<option value="117.93">18st 8lbs</option>
<option value="118.39">18st 9lbs</option>
<option value="118.84">18st 10lbs</option>
<option value="119.29">18st 11lbs</option>
<option value="119.75">18st 12lbs</option>
<option value="120.20">18st 13lbs</option>
<option value="120.66">19st 0lbs</option>
<option value="121.11">19st 1lbs</option>
<option value="121.56">19st 2lbs</option>
<option value="122.02">19st 3lbs</option>
<option value="122.47">19st 4lbs</option>
<option value="122.92">19st 5lbs</option>
<option value="123.38">19st 6lbs</option>
<option value="123.83">19st 7lbs</option>
<option value="124.28">19st 8lbs</option>
<option value="124.74">19st 9lbs</option>
<option value="125.19">19st 10lbs</option>
<option value="125.64">19st 11lbs</option>
<option value="126.10">19st 12lbs</option>
<option value="126.55">19st 13lbs</option>
<option value="127.01">20st 0lbs</option>
<option value="127.46">20st 1lbs</option>
<option value="127.91">20st 2lbs</option>
<option value="128.37">20st 3lbs</option>
<option value="128.82">20st 4lbs</option>
<option value="129.27">20st 5lbs</option>
<option value="129.73">20st 6lbs</option>
<option value="130.18">20st 7lbs</option>
<option value="130.63">20st 8lbs</option>
<option value="131.09">20st 9lbs</option>
<option value="131.54">20st 10lbs</option>
<option value="132.00">20st 11lbs</option>
<option value="132.45">20st 12lbs</option>
<option value="132.90">20st 13lbs</option>
<option value="133.36">21st 0lbs</option>
<option value="133.81">21st 1lbs</option>
<option value="134.26">21st 2lbs</option>
<option value="134.72">21st 3lbs</option>
<option value="135.17">21st 4lbs</option>
<option value="135.62">21st 5lbs</option>
<option value="136.08">21st 6lbs</option>
<option value="136.53">21st 7lbs</option>
<option value="136.98">21st 8lbs</option>
<option value="137.44">21st 9lbs</option>
<option value="137.89">21st 10lbs</option>
<option value="138.35">21st 11lbs</option>
<option value="138.80">21st 12lbs</option>
<option value="139.25">21st 13lbs</option>
<option value="139.71">22st 0lbs</option>
<option value="140.16">22st 1lbs</option>
<option value="140.61">22st 2lbs</option>
<option value="141.07">22st 3lbs</option>
<option value="141.52">22st 4lbs</option>
<option value="141.97">22st 5lbs</option>
<option value="142.43">22st 6lbs</option>
<option value="142.88">22st 7lbs</option>
<option value="143.34">22st 8lbs</option>
<option value="143.79">22st 9lbs</option>
<option value="144.24">22st 10lbs</option>
<option value="144.70">22st 11lbs</option>
<option value="145.15">22st 12lbs</option>
<option value="145.60">22st 13lbs</option>
<option value="146.06">23st 0lbs</option>
<option value="146.51">23st 1lbs</option>
<option value="146.96">23st 2lbs</option>
<option value="147.42">23st 3lbs</option>
<option value="147.87">23st 4lbs</option>
<option value="148.32">23st 5lbs</option>
<option value="148.78">23st 6lbs</option>
<option value="149.23">23st 7lbs</option>
<option value="149.69">23st 8lbs</option>
<option value="150.14">23st 9lbs</option>
<option value="150.59">23st 10lbs</option>
<option value="151.05">23st 11lbs</option>
<option value="151.50">23st 12lbs</option>
<option value="151.95">23st 13lbs</option>
<option value="152.41">24st 0lbs</option>
<option value="152.86">24st 1lbs</option>
<option value="153.31">24st 2lbs</option>
<option value="153.77">24st 3lbs</option>
<option value="154.22">24st 4lbs</option>
<option value="154.67">24st 5lbs</option>
<option value="155.13">24st 6lbs</option>
<option value="155.58">24st 7lbs</option>
<option value="156.04">24st 8lbs</option>
<option value="156.49">24st 9lbs</option>
<option value="156.94">24st 10lbs</option>
<option value="157.40">24st 11lbs</option>
<option value="157.85">24st 12lbs</option>
<option value="158.30">24st 13lbs</option>
<option value="158.80">25st 0lbs</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant1_QuestionSet_8__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_smokinghistory-App1" class="AppAnswers App1Answers Answer8 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_8__ApplicantAnswerID" name="Applicant1.QuestionSet[8].ApplicantAnswerID" type="hidden" value="3269371">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_8__ApplicantId" name="Applicant1.QuestionSet[8].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_8__ApplicationId" name="Applicant1.QuestionSet[8].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_8__QuestionID" name="Applicant1.QuestionSet[8].QuestionID" type="hidden" value="8">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_8__ApplicantNumber" name="Applicant1.QuestionSet[8].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_8__SectionId" name="Applicant1.QuestionSet[8].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App1Answers Answer8 qp_smokinghistory" data-val="true" data-val-required="You must answer this question." id="Applicant1_QuestionSet_8__AnswerValue" name="Applicant1.QuestionSet[8].AnswerValue"
title="Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes.">
<option selected="selected" value="0">Never smoked</option>
<option value="1">Have not smoked for at least 5 years</option>
<option value="2">Have not smoked for at least 12 months</option>
<option value="4">Up to 20 cigarettes per day within last year</option>
<option value="5">Up to 30 cigarettes per day within last year</option>
<option value="6">Up to 40 cigarettes per day within last year</option>
<option value="7">Up to 50 cigarettes per day within last year</option>
<option value="8">More than 50 cigarettes per day within last year</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant1_QuestionSet_9__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_1-alcohol" class="AppAnswers App1Answers Answer9 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_9__ApplicantAnswerID" name="Applicant1.QuestionSet[9].ApplicantAnswerID" type="hidden" value="3269372">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_9__ApplicantId" name="Applicant1.QuestionSet[9].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_9__ApplicationId" name="Applicant1.QuestionSet[9].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_9__QuestionID" name="Applicant1.QuestionSet[9].QuestionID" type="hidden" value="9">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_9__ApplicantNumber" name="Applicant1.QuestionSet[9].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_9__SectionId" name="Applicant1.QuestionSet[9].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[9].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant1_QuestionSet_9__AnswerValue" name="Applicant1.QuestionSet[9].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_10__AnswerValue role=" tooltip"="" class="label--standard">During a typical week, how many alcoholic drinks do you
have?</label>
<div role="tooltip">For example, a drink is a glass of wine or a glass or bottle of beer.</div>
<div data-at="qp_1-alcoholicdrinks" class=" Answer109 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_10__ApplicantAnswerID" name="Applicant1.QuestionSet[10].ApplicantAnswerID" type="hidden" value="3269383">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_10__ApplicantId" name="Applicant1.QuestionSet[10].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_10__ApplicationId" name="Applicant1.QuestionSet[10].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_10__QuestionID" name="Applicant1.QuestionSet[10].QuestionID" type="hidden" value="109">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_10__ApplicantNumber" name="Applicant1.QuestionSet[10].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_10__SectionId" name="Applicant1.QuestionSet[10].SectionId" type="hidden" value="199">
<label for="Applicant1_QuestionSet_10__AnswerValue" class="hidden-label"></label>
<span id="alcohol-1-1" style="display: none" class="field-validation-error">Enter the amount of drinks the policyholder normally has per week. Enter 0 if the policyholder doesn't drink</span>
<span id="alcohol-1-2" style="display: none" class="field-validation-error">This field must be a number.</span>
<span id="alcohol-1-3" style="display: none" class="field-validation-error">Units of Alcohol must be between 0 and 99.</span>
<div class="input-shell input-shell--option">
<div class="input-with-suffix modal-link modal-link--alcohol-calc">
<input class="Question109 OnlyNumbers number-input-width qp_alcoholicdrinks min alc1Sumtotal" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max=""
data-val-range-min="" id="Applicant1_QuestionSet_10__AnswerValue" max="99" maxlength="2" min="0" name="Applicant1.QuestionSet[10].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)" size="2" type="number" value="">
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App1Answers singlePolicySet section-2 hasqplus" id="Section_200_App1" iscomplete="False" style="display: none;">
<div style="display: none;" qp-data="TrouserQuestion" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_11__AnswerValue role=" tooltip"="" class="label--standard">What is your trouser size in UK
inches?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-94-tooltip-trigger" type="checkbox"><label for="qp-1-94-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-94-tooltip" role="tooltip">
<p>Please use the size from the most recent clothing purchase you made for yourself.</p>
</div>
</div>
<div data-at="qp_1-trouser" class="AppAnswers App1Answers Answer94 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_11__ApplicantAnswerID" name="Applicant1.QuestionSet[11].ApplicantAnswerID" type="hidden" value="3269374">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_11__ApplicantId" name="Applicant1.QuestionSet[11].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_11__ApplicationId" name="Applicant1.QuestionSet[11].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_11__QuestionID" name="Applicant1.QuestionSet[11].QuestionID" type="hidden" value="94">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_11__ApplicantNumber" name="Applicant1.QuestionSet[11].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_11__SectionId" name="Applicant1.QuestionSet[11].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[11].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant1_QuestionSet_11__AnswerValue" class="hidden-label"></label>
<span id="Trouser-1-1" style="display: none" class="field-validation-error">The field must be a minimum of 2 digits</span>
<div class="input-shell input-shell--option">
<input class="Question94 TrouserQuestion qp_trouser" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max="" data-val-range-min=""
data-val-required="You must answer this question." id="Applicant1_QuestionSet_11__AnswerValue" max="9999999" maxlength="2" min="0" name="Applicant1.QuestionSet[11].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
<div style="display: none;" qp-data="SkirtQuestion" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_12__AnswerValue role=" tooltip"="" class="label--standard">What is your dress, skirt or trouser
size?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-95-tooltip-trigger" type="checkbox"><label for="qp-1-95-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-95-tooltip" role="tooltip">
<p> Please use the size from the most recent clothing purchase you made for yourself. If you're pregnant, please advise your size prior to this pregnancy.</p>
</div>
</div>
<div data-at="qp_1-skirt" class="AppAnswers App1Answers Answer95 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_12__ApplicantAnswerID" name="Applicant1.QuestionSet[12].ApplicantAnswerID" type="hidden" value="3269375">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_12__ApplicantId" name="Applicant1.QuestionSet[12].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_12__ApplicationId" name="Applicant1.QuestionSet[12].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_12__QuestionID" name="Applicant1.QuestionSet[12].QuestionID" type="hidden" value="95">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_12__ApplicantNumber" name="Applicant1.QuestionSet[12].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_12__SectionId" name="Applicant1.QuestionSet[12].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[12].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant1_QuestionSet_12__AnswerValue" class="hidden-label"></label>
<div class="input-shell input-shell--option">
<input class="Question95 SkirtQuestion qp_skirt" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max="" data-val-range-min=""
data-val-required="You must answer this question." id="Applicant1_QuestionSet_12__AnswerValue" max="9999999" maxlength="2" min="0" name="Applicant1.QuestionSet[12].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
<div style="" qp-data="Last2YearsMale-App1" class="field-group extra-questions "><label for="Applicant1_QuestionSet_13__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years, have you seen a health professional
about:</label>
<ul class="standard-list">
<li>a blood condition for example anaemia, blood clot? </li>
<li>a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? </li>
<li>a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? </li>
<li>any type of arthritis or gout? </li>
<li>a growth, lump, polyp or tumour? </li>
<li>anxiety, depression or any other type of mental illness? </li>
<li>any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have
fully recovered? </li>
</ul>
<div data-at="qp_1-anxiety-m" class="AppAnswers App1Answers Answer124 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_13__ApplicantAnswerID" name="Applicant1.QuestionSet[13].ApplicantAnswerID" type="hidden" value="3269390">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_13__ApplicantId" name="Applicant1.QuestionSet[13].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_13__ApplicationId" name="Applicant1.QuestionSet[13].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_13__QuestionID" name="Applicant1.QuestionSet[13].QuestionID" type="hidden" value="124">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_13__ApplicantNumber" name="Applicant1.QuestionSet[13].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_13__SectionId" name="Applicant1.QuestionSet[13].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[13].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_13__AnswerValue_1" value="1" name="Applicant1.QuestionSet[13].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_13__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_13__AnswerValue_0" value="0" name="Applicant1.QuestionSet[13].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_13__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_13__AnswerValue" name="Applicant1.QuestionSet[13].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last2YearsFemale-App1" class="field-group extra-questions "><label for="Applicant1_QuestionSet_14__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years, have you seen a health professional
about:</label>
<ul class="standard-list">
<li>a blood condition for example anaemia, blood clot? </li>
<li>a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? </li>
<li>a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? </li>
<li>any type of arthritis or gout? </li>
<li>a growth, lump, polyp or tumour? </li>
<li>anxiety, depression or any other type of mental illness? </li>
<li>any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have
fully recovered or pregnancy, contraceptive and infertility medication? </li>
</ul>
<div data-at="qp_1-anxiety-f" class="AppAnswers App1Answers Answer125 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_14__ApplicantAnswerID" name="Applicant1.QuestionSet[14].ApplicantAnswerID" type="hidden" value="3269391">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_14__ApplicantId" name="Applicant1.QuestionSet[14].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_14__ApplicationId" name="Applicant1.QuestionSet[14].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_14__QuestionID" name="Applicant1.QuestionSet[14].QuestionID" type="hidden" value="125">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_14__ApplicantNumber" name="Applicant1.QuestionSet[14].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_14__SectionId" name="Applicant1.QuestionSet[14].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[14].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_14__AnswerValue_1" value="1" name="Applicant1.QuestionSet[14].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_14__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_14__AnswerValue_0" value="0" name="Applicant1.QuestionSet[14].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_14__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_14__AnswerValue" name="Applicant1.QuestionSet[14].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_15__AnswerValue role=" tooltip"="" class="label--standard">Have any of your natural parents, brothers or sisters, before the age of 60, had any
of the following?</label>
<ul class="standard-list">
<li>Alzheimer's disease or dementia </li>
<li>Cancer of the bowel (colon), breast or ovary </li>
<li>Cardiomyopathy </li>
<li>Heart attack, diabetes or stroke </li>
<li>Huntington's disease </li>
<li>Motor neurone disease </li>
<li>Multiple sclerosis </li>
<li>Myotonic Dystrophy </li>
<li>Parkinson's disease </li>
<li>Polycystic kidney disease </li>
<li>Any other condition that runs in your family and that you're receiving regular follow up or screening for </li>
<li>Don't know</li>
</ul>
<div data-at="qp_1-familyhistory" class="AppAnswers App1Answers Answer118 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_15__ApplicantAnswerID" name="Applicant1.QuestionSet[15].ApplicantAnswerID" type="hidden" value="3269384">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_15__ApplicantId" name="Applicant1.QuestionSet[15].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_15__ApplicationId" name="Applicant1.QuestionSet[15].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_15__QuestionID" name="Applicant1.QuestionSet[15].QuestionID" type="hidden" value="118">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_15__ApplicantNumber" name="Applicant1.QuestionSet[15].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_15__SectionId" name="Applicant1.QuestionSet[15].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[15].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_15__AnswerValue_1" value="1" name="Applicant1.QuestionSet[15].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_15__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_15__AnswerValue_0" value="0" name="Applicant1.QuestionSet[15].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_15__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_15__AnswerValue" name="Applicant1.QuestionSet[15].AnswerValue" type="hidden" value="">
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App1Answers singlePolicySet section-3 hasqplus" id="Section_201_App1" iscomplete="False" style="display: none;">
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_16__AnswerValue role=" tooltip"="" class="label--standard">Have you ever:</label>
<ul class="standard-list">
<li>had diabetes, excess sugar in the blood or a heart condition for example angina, heart attack, heart valve problem, heart surgery? </li>
<li>had a stroke, transient ischaemic attack (TIA) or a brain haemorrhage? </li>
<li>had cancer, Hodgkin's disease, Non-Hodgkin's lymphoma, leukaemia, a melanoma or a brain tumour? </li>
<li>had a neurological condition for example cerebral palsy, epilepsy, motor neurone disease, multiple sclerosis, muscular dystrophy, optic neuritis, paralysis, Parkinson's disease </li>
<li>been admitted overnight to hospital or referred to a psychiatrist for mental illness, anorexia or bulimia? </li>
<li>tested positive for HIV, or are you waiting for the result of an HIV test? </li>
</ul>
<div data-at="qp_1-diabetes" class="AppAnswers App1Answers Answer120 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_16__ApplicantAnswerID" name="Applicant1.QuestionSet[16].ApplicantAnswerID" type="hidden" value="3269386">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_16__ApplicantId" name="Applicant1.QuestionSet[16].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_16__ApplicationId" name="Applicant1.QuestionSet[16].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_16__QuestionID" name="Applicant1.QuestionSet[16].QuestionID" type="hidden" value="120">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_16__ApplicantNumber" name="Applicant1.QuestionSet[16].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_16__SectionId" name="Applicant1.QuestionSet[16].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[16].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_16__AnswerValue_1" value="1" name="Applicant1.QuestionSet[16].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_16__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_16__AnswerValue_0" value="0" name="Applicant1.QuestionSet[16].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_16__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_16__AnswerValue" name="Applicant1.QuestionSet[16].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last5YearsMale-App1" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_17__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years, have you seen a
health professional about:</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-122-tooltip-trigger" type="checkbox"><label for="qp-1-122-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-122-tooltip" role="tooltip">
<p>Please ignore birthmarks where no treatment or specialist referral has been advised.</p>
</div>
</div>
<ul class="standard-list">
<li>raised blood pressure? </li>
<li>raised cholesterol? </li>
<li>a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? </li>
<li>chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? </li>
<li>a mole or freckle? </li>
<li>any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? </li>
</ul>
<div data-at="qp_1-bloodpressure-m" class="AppAnswers App1Answers Answer122 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_17__ApplicantAnswerID" name="Applicant1.QuestionSet[17].ApplicantAnswerID" type="hidden" value="3269388">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_17__ApplicantId" name="Applicant1.QuestionSet[17].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_17__ApplicationId" name="Applicant1.QuestionSet[17].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_17__QuestionID" name="Applicant1.QuestionSet[17].QuestionID" type="hidden" value="122">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_17__ApplicantNumber" name="Applicant1.QuestionSet[17].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_17__SectionId" name="Applicant1.QuestionSet[17].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[17].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_17__AnswerValue_1" value="1" name="Applicant1.QuestionSet[17].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_17__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_17__AnswerValue_0" value="0" name="Applicant1.QuestionSet[17].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_17__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_17__AnswerValue" name="Applicant1.QuestionSet[17].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last5YearsFemale-App1" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_18__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years, have you seen a
health professional about:</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-123-tooltip-trigger" type="checkbox"><label for="qp-1-123-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-123-tooltip" role="tooltip">
<p>Please ignore routine cervical smears if the results have been normal. Please ignore birthmarks where no treatment or specialist referral has been advised.</p>
</div>
</div>
<ul class="standard-list">
<li>raised blood pressure? </li>
<li>raised cholesterol? </li>
<li>a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? </li>
<li>chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? </li>
<li>a mole or freckle? </li>
<li>any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? </li>
<li>any gynaecological condition for which you've not yet been discharged from follow up, or a cervical smear requiring further investigations? </li>
</ul>
<div data-at="qp_1-bloodpressure-f" class="AppAnswers App1Answers Answer123 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_18__ApplicantAnswerID" name="Applicant1.QuestionSet[18].ApplicantAnswerID" type="hidden" value="3269389">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_18__ApplicantId" name="Applicant1.QuestionSet[18].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_18__ApplicationId" name="Applicant1.QuestionSet[18].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_18__QuestionID" name="Applicant1.QuestionSet[18].QuestionID" type="hidden" value="123">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_18__ApplicantNumber" name="Applicant1.QuestionSet[18].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_18__SectionId" name="Applicant1.QuestionSet[18].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[18].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_18__AnswerValue_1" value="1" name="Applicant1.QuestionSet[18].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_18__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_18__AnswerValue_0" value="0" name="Applicant1.QuestionSet[18].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_18__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_18__AnswerValue" name="Applicant1.QuestionSet[18].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_19__AnswerValue role=" tooltip"="" class="label--standard">During the last 3 months, have you had:</label>
<ul class="standard-list">
<li>unexplained bleeding, weight loss, lump or growth? </li>
<li>breast or testicular changes of any sort? </li>
<li>a mole or freckle that has bled or changed in appearance or any other changes to your skin? </li>
<li>any other symptom for which you may see a health professional about for the first time? </li>
</ul>
<div data-at="qp_1-lastthreemonths" class="AppAnswers App1Answers Answer121 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_19__ApplicantAnswerID" name="Applicant1.QuestionSet[19].ApplicantAnswerID" type="hidden" value="3269387">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_19__ApplicantId" name="Applicant1.QuestionSet[19].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_19__ApplicationId" name="Applicant1.QuestionSet[19].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_19__QuestionID" name="Applicant1.QuestionSet[19].QuestionID" type="hidden" value="121">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_19__ApplicantNumber" name="Applicant1.QuestionSet[19].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_19__SectionId" name="Applicant1.QuestionSet[19].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[19].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_19__AnswerValue_1" value="1" name="Applicant1.QuestionSet[19].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_19__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_19__AnswerValue_0" value="0" name="Applicant1.QuestionSet[19].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_19__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_19__AnswerValue" name="Applicant1.QuestionSet[19].AnswerValue" type="hidden" value="">
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App1Answers singlePolicySet section-4 hasqplus" id="Section_202_App1" iscomplete="False" style="display: none;">
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_20__AnswerValue role=" tooltip"="" class="label--standard">Do you regularly take part in any of the following activities
for work or recreation?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-104-tooltip-trigger" type="checkbox"><label for="qp-1-104-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-104-tooltip" role="tooltip">
<p>You can ignore one off parachute jumps</p>
</div>
</div>
<ul class="standard-list">
<li>Flying (other than as a fare-paying passenger) </li>
<li>Hang gliding or paragliding </li>
<li>Motor car or motorcycle sport </li>
<li>Mountaineering or rock climbing </li>
<li>Parachuting, sky diving or BASE jumping </li>
<li>Underwater diving </li>
<li>Any other extreme sport</li>
</ul>
<div data-at="qp_1-pastimes" class="AppAnswers App1Answers Answer104 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_20__ApplicantAnswerID" name="Applicant1.QuestionSet[20].ApplicantAnswerID" type="hidden" value="3269379">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_20__ApplicantId" name="Applicant1.QuestionSet[20].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_20__ApplicationId" name="Applicant1.QuestionSet[20].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_20__QuestionID" name="Applicant1.QuestionSet[20].QuestionID" type="hidden" value="104">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_20__ApplicantNumber" name="Applicant1.QuestionSet[20].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_20__SectionId" name="Applicant1.QuestionSet[20].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[20].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_20__AnswerValue_1" value="1" name="Applicant1.QuestionSet[20].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_20__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_20__AnswerValue_0" value="0" name="Applicant1.QuestionSet[20].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_20__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_20__AnswerValue" name="Applicant1.QuestionSet[20].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_21__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years have you spent more than 90 consecutive days in Africa, the
Caribbean, Russia, Thailand or Ukraine?</label>
<div data-at="qp_1-travelling" class="AppAnswers App1Answers Answer105 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_21__ApplicantAnswerID" name="Applicant1.QuestionSet[21].ApplicantAnswerID" type="hidden" value="3269380">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_21__ApplicantId" name="Applicant1.QuestionSet[21].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_21__ApplicationId" name="Applicant1.QuestionSet[21].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_21__QuestionID" name="Applicant1.QuestionSet[21].QuestionID" type="hidden" value="105">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_21__ApplicantNumber" name="Applicant1.QuestionSet[21].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_21__SectionId" name="Applicant1.QuestionSet[21].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[21].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_21__AnswerValue_1" value="1" name="Applicant1.QuestionSet[21].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_21__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_21__AnswerValue_0" value="0" name="Applicant1.QuestionSet[21].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_21__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_21__AnswerValue" name="Applicant1.QuestionSet[21].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_22__AnswerValue role=" tooltip"="" class="label--standard">During the next 2 years do you intend to spend more than 30
consecutive days outside the UK, EU, USA, Canada, Australia or New Zealand?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-106-tooltip-trigger" type="checkbox"><label for="qp-1-106-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-106-tooltip" role="tooltip">
<p>You can ignore travel as a member of the Armed Forces</p>
</div>
</div>
<div data-at="qp_1-moretravelling" class="AppAnswers App1Answers Answer106 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_22__ApplicantAnswerID" name="Applicant1.QuestionSet[22].ApplicantAnswerID" type="hidden" value="3269381">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_22__ApplicantId" name="Applicant1.QuestionSet[22].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_22__ApplicationId" name="Applicant1.QuestionSet[22].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_22__QuestionID" name="Applicant1.QuestionSet[22].QuestionID" type="hidden" value="106">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_22__ApplicantNumber" name="Applicant1.QuestionSet[22].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_22__SectionId" name="Applicant1.QuestionSet[22].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[22].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_22__AnswerValue_1" value="1" name="Applicant1.QuestionSet[22].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_22__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_22__AnswerValue_0" value="0" name="Applicant1.QuestionSet[22].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_22__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_22__AnswerValue" name="Applicant1.QuestionSet[22].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_23__AnswerValue role=" tooltip"="" class="label--standard">Do you work outside at heights over 15 metres (50ft), offshore in the oil, gas or
fishing industry, in the Armed Forces or as a member of the army reserve?</label>
<div data-at="qp_1-aboutyourjob" class="AppAnswers App1Answers Answer107 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_23__ApplicantAnswerID" name="Applicant1.QuestionSet[23].ApplicantAnswerID" type="hidden" value="3269382">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_23__ApplicantId" name="Applicant1.QuestionSet[23].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_23__ApplicationId" name="Applicant1.QuestionSet[23].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_23__QuestionID" name="Applicant1.QuestionSet[23].QuestionID" type="hidden" value="107">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_23__ApplicantNumber" name="Applicant1.QuestionSet[23].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_23__SectionId" name="Applicant1.QuestionSet[23].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[23].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_23__AnswerValue_1" value="1" name="Applicant1.QuestionSet[23].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_23__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_23__AnswerValue_0" value="0" name="Applicant1.QuestionSet[23].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_23__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_23__AnswerValue" name="Applicant1.QuestionSet[23].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_24__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years have you been disqualified from driving for a motoring offence
or convicted of careless or reckless driving?</label>
<div data-at="qp_1-driving" class="AppAnswers App1Answers Answer100 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_24__ApplicantAnswerID" name="Applicant1.QuestionSet[24].ApplicantAnswerID" type="hidden" value="3269376">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_24__ApplicantId" name="Applicant1.QuestionSet[24].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_24__ApplicationId" name="Applicant1.QuestionSet[24].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_24__QuestionID" name="Applicant1.QuestionSet[24].QuestionID" type="hidden" value="100">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_24__ApplicantNumber" name="Applicant1.QuestionSet[24].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_24__SectionId" name="Applicant1.QuestionSet[24].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[24].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_24__AnswerValue_1" value="1" name="Applicant1.QuestionSet[24].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_24__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_24__AnswerValue_0" value="0" name="Applicant1.QuestionSet[24].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_24__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_24__AnswerValue" name="Applicant1.QuestionSet[24].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_25__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years have you used any of the
following?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-102-tooltip-trigger" type="checkbox"><label for="qp-1-102-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-102-tooltip" role="tooltip">
<p>We'll only use the answer to this question to assess your application and at claim stage. Therefore there are no 'legal implications' in answering yes to this question.</p>
</div>
</div>
<ul class="standard-list">
<li>Recreational drugs, for example cocaine, ecstasy, heroin </li>
<li>Methadone </li>
<li>Anabolic steroids not prescribed by a doctor</li>
</ul>
<div data-at="qp_1-druguse" class="AppAnswers App1Answers Answer102 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_25__ApplicantAnswerID" name="Applicant1.QuestionSet[25].ApplicantAnswerID" type="hidden" value="3269377">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_25__ApplicantId" name="Applicant1.QuestionSet[25].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_25__ApplicationId" name="Applicant1.QuestionSet[25].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_25__QuestionID" name="Applicant1.QuestionSet[25].QuestionID" type="hidden" value="102">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_25__ApplicantNumber" name="Applicant1.QuestionSet[25].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_25__SectionId" name="Applicant1.QuestionSet[25].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[25].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_25__AnswerValue_1" value="1" name="Applicant1.QuestionSet[25].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_25__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_25__AnswerValue_0" value="0" name="Applicant1.QuestionSet[25].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_25__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_25__AnswerValue" name="Applicant1.QuestionSet[25].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant1_QuestionSet_26__AnswerValue role=" tooltip"="" class="label--standard">Have you ever been:</label>
<ul class="standard-list">
<li>told by a health professional that you should reduce the amount of alcohol you have because you were drinking too much? </li>
<li>seen by an alcohol specialist or attended an alcohol support group or been told that you have any liver damage? </li>
</ul>
<div data-at="qp_1-reducealcohol" class="AppAnswers App1Answers Answer103 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_26__ApplicantAnswerID" name="Applicant1.QuestionSet[26].ApplicantAnswerID" type="hidden" value="3269378">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_26__ApplicantId" name="Applicant1.QuestionSet[26].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_26__ApplicationId" name="Applicant1.QuestionSet[26].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_26__QuestionID" name="Applicant1.QuestionSet[26].QuestionID" type="hidden" value="103">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_26__ApplicantNumber" name="Applicant1.QuestionSet[26].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_26__SectionId" name="Applicant1.QuestionSet[26].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[26].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_26__AnswerValue_1" value="1" name="Applicant1.QuestionSet[26].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_26__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant1_QuestionSet_26__AnswerValue_0" value="0" name="Applicant1.QuestionSet[26].AnswerValue" class="replaced-input">
<label for="Applicant1_QuestionSet_26__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant1_QuestionSet_26__AnswerValue" name="Applicant1.QuestionSet[26].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant1_QuestionSet_27__AnswerValue role=" tooltip"="" class="label--standard">Including this application, what is the total amount of life and
critical illness cover you will have?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-1-119-tooltip-trigger" type="checkbox"><label for="qp-1-119-tooltip-trigger"><span>More details</span></label>
<div id="qp-1-119-tooltip" role="tooltip">
<p>Please include any applications being made to another insurer but ignore cover that will be cancelled if this policy goes ahead.</p>
</div>
</div>
<div data-at="qp_1-totalcover" class="AppAnswers App1Answers Answer119 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant1_QuestionSet_27__ApplicantAnswerID" name="Applicant1.QuestionSet[27].ApplicantAnswerID" type="hidden" value="3269385">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant1_QuestionSet_27__ApplicantId" name="Applicant1.QuestionSet[27].ApplicantId" type="hidden" value="216829">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant1_QuestionSet_27__ApplicationId" name="Applicant1.QuestionSet[27].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant1_QuestionSet_27__QuestionID" name="Applicant1.QuestionSet[27].QuestionID" type="hidden" value="119">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant1_QuestionSet_27__ApplicantNumber" name="Applicant1.QuestionSet[27].ApplicantNumber" type="hidden" value="1">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant1_QuestionSet_27__SectionId" name="Applicant1.QuestionSet[27].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant1.QuestionSet[27].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant1_QuestionSet_27__AnswerValue" class="hidden-label"></label>
<span id="TotalAmount-1-1" style="display: none" class="field-validation-error">Total amount is required</span>
<span id="TotalAmount-1-2" style="display: none" class="field-validation-error">The field Amount of cover must be a number.</span>
<span id="TotalAmount-1-3" style="display: none" class="field-validation-error">Total amount must not be less than the sum assured.</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width qp_totalcover" id="Applicant1_QuestionSet_27__AnswerValue" max="9999999" maxlength="9" min="5000" name="Applicant1.QuestionSet[27].AnswerValue"
oninput="this.value=this.value.slice(0,this.maxLength)" size="10" step="1" type="number" value="">
</div>
</div>
</div>
</fieldset>
<div class="terms-and-conditions">
<div class="terms-and-conditions__panel">
<div id="ExplicitConsentSection">
<div class="field-validation-error" aria-live="assertive" style="display:none" id="explicitConsent-error"> Tick the box to continue getting a quote. For more information on Direct Life and Pension Services, see their
<a style="color:#E61414" href="/PrivacyPolicy?ReferralSource=money_ol&SearchEngine" target="_blank">privacy policy</a>.</div>
<div class="input-shell input-shell--plain">
<input type="checkbox" aria-describedby="confirmTandC-error" id="ExplicitConsentAgreement">
<label id="lblExplicitConsent" for="aca1"> I consent to Money processing my personal data to provide a life insurance service and sharing data with money.co.uk and quoting Insurers. I have read and accept both <a href="/PrivacyPolicy?ReferralSource=Money_ol&SearchEngine" target="_blank">
DLPS privacy policy</a> and that of <a href="https://www.money.co.uk/privacy-policy" target="_blank">Money.co.uk's privacy policy</a> and
<a href="https://www.money.co.uk/terms-and-conditions" target="_blank">terms and conditions</a> and understand that I can withdraw consent at any time. </label>
</div>
</div>
</div>
</div>
</div>
<div id="app2EditBox" class="panel" style="display: none;">
<div class="applicantEditText">
<strong>,</strong>
<input type="button" value="Edit" class="btn--transparent" id="btnApp2Edit">
</div>
</div>
<div id="app2Edit">
<input id="Applicant2_DoB" name="Applicant2.DoB" type="hidden" value="">
<input data-val="true" data-val-required="The URN field is required." id="Applicant2_URN" name="Applicant2.URN" type="hidden" value="">
<input data-val="true" data-val-required="The Applicant field is required." id="Applicant2_Applicant" name="Applicant2.Applicant" type="hidden" value="2">
<input id="Applicant2_Smoke" name="Applicant2.Smoke" type="hidden" value="">
<input data-val="true" data-val-required="The Sex field is required." id="Applicant2_Sex" name="Applicant2.Sex" type="hidden" value="">
<input data-val="true" data-val-required="The AppIsValid field is required." id="Applicant2_AppIsValid" name="Applicant2.AppIsValid" type="hidden" value="False">
<input data-val="true" data-val-required="The MinDDValue field is required." id="Applicant2_MinDDValue" name="Applicant2.MinDDValue" type="hidden" value="0">
<input data-val="true" data-val-required="The MaxDDValue field is required." id="Applicant2_MaxDDValue" name="Applicant2.MaxDDValue" type="hidden" value="0">
<input id="Applicant2_ExplicitConsent" name="Applicant2.ExplicitConsent" type="hidden" value="">
<input data-val="true" data-val-required="The RequestedCallback field is required." id="Applicant2_RequestedCallback" name="Applicant2.RequestedCallback" type="hidden" value="">
<div class="bordered-section jointPolicySet hasqplus" style="display: none;">
<h3 class="section-heading">About other applicant</h3>
<div class="field-group">
<input id="Applicant2_AppTitle" name="Applicant2.AppTitle" type="hidden" value="">
<label class="label--standard" for="Applicant1_AppTitle">Title</label>
<div role="tooltip">We recognise not all titles are included here and so may not represent you as it should.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="app2title-tooltip-trigger" type="checkbox">
<label for="app2title-tooltip-trigger"><span id="ht_2-title">Why isn't my title listed?</span></label>
<div id="app2title-tooltip" role="tooltip">
<p>For now these titles are what our system and insurance providers use. We're working to add in more inclusive titles.</p>
</div>
</div>
<span id="Applicant2.AppTitle" style="display: none;" class="field-validation-error">Select the policyholder's title</span>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_AppTitle-1" value="Mr" name="Applicant2.AppTitle" class="replaced-input">
<label id="title_2-mr" for="Applicant2_AppTitle-1">Mr</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_AppTitle-2" value="Mrs" name="Applicant2.AppTitle" class="replaced-input">
<label id="title_2-mrs" for="Applicant2_AppTitle-2" class="replaced-input-label replaced-input-label--radio">Mrs</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_AppTitle-3" value="Ms" name="Applicant2.AppTitle" class="replaced-input">
<label id="title_2-ms" for="Applicant2_AppTitle-3" class="replaced-input-label replaced-input-label--radio">Ms</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_AppTitle-4" value="Miss" name="Applicant2.AppTitle" class="replaced-input">
<label id="title_2-miss" for="Applicant2_AppTitle-4" class="replaced-input-label replaced-input-label--radio">Miss</label>
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Applicant2_Forename">First name</label>
<span id="Applicant2.Forename" style="display: none;" class="field-validation-error">Enter the policyholder's first name</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant2_Forename" maxlength="18" name="Applicant2.Forename" onkeypress="return /[a-zA-Z-_]/i.test(event.key)" size="20" type="text" value="">
</div>
</div>
<div class="field-group">
<label class="label--standard" for="Applicant2_Surname">Surname</label>
<span id="Applicant2.Surname" style="display: none;" class="field-validation-error">Enter the policyholder's surname</span>
<div class="input-shell input-shell--standard">
<input class="standard-width" id="Applicant2_Surname" maxlength="35" name="Applicant2.Surname" onkeypress="return /[a-zA-Z-_]/i.test(event.key)" size="20" type="text" value="">
</div>
</div>
<div class="field-group">
<label class="label--standard" id="dob"> <span>Date of birth</span></label>
<span id="Applicant2.DOBDD-2" style="display: none;" class="field-validation-error">Enter the birth day, month and year as numbers</span>
<span id="Applicant2.DOBDD-1" style="display: none;" class="field-validation-error">Please select a valid date of birth.</span>
<div class="date-field">
<label for="Applicant2_DOBDD">Day</label>
<div>
<input class="day-month" id="Applicant2_DOBDD" maxlength="2" name="Applicant2.DOBDD" placeholder="DD" type="text" value="">
</div>
</div>
<div class="date-field">
<label for="Applicant2_DOBMM">Month</label>
<div>
<input class="day-month" id="Applicant2_DOBMM" maxlength="2" name="Applicant2.DOBMM" placeholder="MM" type="text" value="">
</div>
</div>
<div class="date-field">
<label for="Applicant2_DOBYYYY">Year</label>
<div>
<input id="Applicant2_DOBYYYY" maxlength="4" name="Applicant2.DOBYYYY" placeholder="YYYY" type="text" value="">
</div>
</div>
</div>
<div class="field-group">
<div class="label--standard" for="Applicant2_PostCode">Postcode</div>
<span id="Applicant2.PostCode" style="display: none;" class="field-validation-error">Please enter a valid UK postcode</span>
<div class="input-shell input-shell--spaced">
<input class="half-width medium" id="Applicant2_PostCode" name="Applicant2.PostCode" size="20" type="text" value="" maxlength="10">
</div>
</div>
<div class="field-group AppAnswers App2Answers">
<label class="label--standard">What's your height?</label>
<div role="tooltip">Select how you measure your height</div>
<span id="error-Applicant2.IsMetricHeight-radio" style="display: none;" class="field-validation-error">Select if you measure in centimetres or feet/inches</span>
<input id="Applicant2_IsMetricHeight" name="Applicant2.IsMetricHeight" type="hidden" value="">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsMetricHeight-1" value="1" name="Applicant2.IsMetricHeight" class="replaced-input">
<label id="heightcm_2" for="Applicant2_IsMetricHeight-1">Centimetres</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsMetricHeight-2" value="0" name="Applicant2.IsMetricHeight" class="replaced-input">
<label id="heightfeet_2" for="Applicant2_IsMetricHeight-2">Feet/inches</label>
</div>
</div>
<div class="field-group field-group--indented Applicant-2-heightsection AppAnswers App2Answers" style="display: none;">
<div role="tooltip">We need your height without shoes on</div>
<span id="Applicant2.HeightFeet-1" style="display: none;" class="field-validation-error">Enter a height between 91.44 - 210.82 cm. If you're shorter or taller, call 0800 422 0060 for further help</span>
<span id="Applicant2.HeightFeet-2" style="display: none;" class="field-validation-error">Enter a height between 3ft - 6ft 11. If you're shorter or taller, call 0800 422 0060 for further help</span>
<span id="Applicant2.HeightFeet-range-imperial" style="display: none;" class="field-validation-error">Allowable range 3ft - 6ft 11 inches. If outside of this range, please call 0800 422 0060.</span>
<span id="Applicant2.HeightFeet-range-metric" style="display: none;" class="field-validation-error">Allowable range 92cm - 211cm. If outside of this range, please call 0800 422 0060.</span>
<div id="Applicant-2-height-imperial" data-tooltip="height-2" class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label style="width: 45px;" for="Applicant2_HeightFeet">Feet</label>
<div>
<input class="OnlyNumbers number-input-width" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between 3 and 6" data-val-range-max="6" data-val-range-min="3"
data-val-required="You must answer this question." id="Applicant2_HeightFeet" max="6" maxlength="1" min="3" name="Applicant2.HeightFeet" oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1"
type="number" value="">
</div>
</div>
</div>
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label style="width: 45px;" for="Applicant2_HeightInches" class="">Inches</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between 0 and 11" data-val-range-max="11" data-val-range-min="0"
data-val-required="You must answer this question." id="Applicant2_HeightInches" max="11" maxlength="2" min="0" name="Applicant2.HeightInches" oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1"
type="number" value="">
</div>
</div>
</div>
</div>
<div id="Applicant-2-height-metric" class="date-field">
<label for="Applicant2_HeightCentimeters">Centimetres</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The HeightCentimeters field is required." id="Applicant2_HeightCentimeters" maxlength="3" name="Applicant2.HeightCentimeters"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" step="1" type="number" value="">
</div>
</div>
</div>
<div class="field-group AppAnswers App2Answers">
<label class="label--standard">What's your weight?</label>
<div role="tooltip">Select how you measure your weight</div>
<span id="error-Applicant2.IsMetricWeight-radio" style="display: none;" class="field-validation-error">Select if you measure in kilograms or stones/pounds</span>
<input id="Applicant2_IsMetricWeight" name="Applicant2.IsMetricWeight" type="hidden" value="">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsMetricWeight-1" value="1" name="Applicant2.IsMetricWeight" class="replaced-input">
<label id="weightkg_2" for="Applicant2_IsMetricWeight-1">Kilograms</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsMetricWeight-2" value="0" name="Applicant2.IsMetricWeight" class="replaced-input">
<label id="weightstone_2" for="Applicant2_IsMetricWeight-2">Stone/pounds</label>
</div>
</div>
<div class="field-group field-group--indented Applicant-2-weightsection AppAnswers App2Answers" style="display: none;">
<div role="tooltip">We need your weight to include wearing clothes</div>
<span id="Applicant2.WeightStone-1" style="display: none;" class="field-validation-error">Enter a weight between 31.75 - 153.23kg. If weight is outside this range, call 0800 422 0060 for further help</span>
<span id="Applicant2.WeightStone-2" style="display: none;" class="field-validation-error">Enter a weight between 5st - 24st 13lbs. If weight is outside this range, call 0800 422 0060 for further help</span>
<span id="Applicant2.WeightStone-range-imperial" style="display: none;" class="field-validation-error">Allowable range 5st - 24st 13lbs. If outside of this range, please call 0800 422 0060.</span>
<span id="Applicant2.WeightStone-range-metric" style="display: none;" class="field-validation-error">Allowable range 32kg - 158kg. If outside of this range, please call 0800 422 0060.</span>
<div id="Applicant-2-weight-imperial" data-at="qp_2-weight" class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label for="Applicant2_WeightStone">Stone</label>
<div>
<input class="OnlyNumbers number-input-width" data-val="true" data-val-required="The WeightStone field is required." id="Applicant2_WeightStone" max="24" maxlength="2" min="5" name="Applicant2.WeightStone"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1" type="number" value="">
</div>
</div>
</div>
<div class="input-shell input-shell--option input-shell--horizontal">
<div class="date-field">
<label for="Applicant2_WeightPounds" class="">Pounds</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The WeightPounds field is required." id="Applicant2_WeightPounds" max="13" maxlength="2" min="0" name="Applicant2.WeightPounds"
oninput="this.value=this.value.slice(0,this.maxLength)" pattern="[0-9]*" size="2" step="1" type="number" value="">
</div>
</div>
</div>
</div>
<div id="Applicant-2-weight-metric" class="date-field">
<label for="Applicant2_WeightKilograms">Kilograms</label>
<div>
<input class="OnlyNumbers" data-val="true" data-val-required="The WeightKilograms field is required." id="Applicant2_WeightKilograms" maxlength="3" name="Applicant2.WeightKilograms" oninput="this.value=this.value.slice(0,this.maxLength)"
pattern="[0-9]*" step="1" type="number" value="">
</div>
</div>
</div>
</div>
<div class="field-group AppAnswers App2Answers jointPolicySet" style="display: none;">
<h3 class="section-heading">Lifestyle</h3>
<div class="field-group smoking-status">
<input data-val="true" data-val-required="The SmokerStatus field is required." id="Applicant2_SmokerStatus" name="Applicant2.SmokerStatus" type="hidden" value="0">
<label class="label--standard">Do you smoke?</label>
<div role="tooltip">If you've smoked in the last 12 months you're classed as a 'current smoker'. This includes cigars, pipes, e-cigarettes, nicotine replacements and regular cigarettes.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="smoker-2-tooltip-trigger" type="checkbox">
<label for="smoker-2-tooltip-trigger"><span id="ht_2-smoker">How do you class smokers?</span></label>
<div id="smoker-2-tooltip" role="tooltip">
<p>Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes.</p>
</div>
</div>
<span class="label-style field-validation-error" id="err-SmokerStatus-2" style="display:none">Select if the policyholder has ever smoked</span>
<div data-at="qp_2-issmoker">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_SmokerStatus-2" value="2" name="Applicant2.SmokerStatus" class="replaced-input smokerNow">
<label id="smokercurrent_2" for="Applicant2_SmokerStatus-2" class="replaced-input-label replaced-input-label--radio">Yes - current smoker</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_SmokerStatus-3" value="3" name="Applicant2.SmokerStatus" class="replaced-input smokerEx">
<label id="smokerex_2" for="Applicant2_SmokerStatus-3" class="replaced-input-label replaced-input-label--radio">Yes - ex-smoker</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_SmokerStatus-1" value="1" name="Applicant2.SmokerStatus" class="replaced-input smokerNever">
<label id="smokernever_2" for="Applicant2_SmokerStatus-1" class="replaced-input-label replaced-input-label--radio">No - never smoked</label>
</div>
</div>
</div>
<div class="field-group field-group--indented ex-smoker" style="display: none;">
<div class="field-group past-smoker">
<span class="label--standard">When did you quit?</span>
<input data-val="true" data-val-required="The When did you quit? field is required." id="Applicant2_IsYearsSinceSmoked" name="Applicant2.IsYearsSinceSmoked" type="hidden" value="0">
<div role="tooltip">If you've quit within last 12 months or used a nicotine replacement within this timeframe you're classed as a smoker.</div>
<div class="input-shell input-shell--tooltip">
<input class="tooltip-trigger" id="exsmoker-2-tooltip-trigger" type="checkbox">
<label for="exsmoker-2-tooltip-trigger"><span>More details</span></label>
<div id="exsmoker-2-tooltip" role="tooltip">
<p>If you have smoked or used any tobacco products (including cigars, a pipe, cigarettes or nicotine replacement products) in the last 12 months then you are classified as a smoker.</p>
</div>
</div>
<div data-at="qp_2-smokinghistory" class="input-group">
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsYearsSinceSmoked-1" value="0" name="Applicant2.IsYearsSinceSmoked" class="replaced-input lttma" checked="checked">
<label id="exsmokerless12_2" for="Applicant2_IsYearsSinceSmoked-1">Less than 12 months ago</label>
</div>
<div class="input-shell input-shell--option">
<input type="radio" id="Applicant2_IsYearsSinceSmoked-2" value="1" name="Applicant2.IsYearsSinceSmoked" class="replaced-input mttma">
<label id="exsmokermore12_2" for="Applicant2_IsYearsSinceSmoked-2" class="replaced-input-label replaced-input-label--radio">More than 12 months ago</label>
</div>
</div>
</div>
<div class="field-group field-group--indented smoke-amount" style="display: none;">
<label class="label--standard" for="Applicant2_DailySmokingAmount">On average, how many cigarettes or equivalent did you or do you smoke per day?</label>
<span id="err-SmokePerDay-2" class="field-validation-error" style="display: none;">Enter policyholder's average daily amount of cigarettes or equivalent</span>
<div class="date-field">
<label for="Applicant2_DailySmokingAmount">Per day</label>
<div>
<input class="number-input-width" data-qp-target-field="8" data-val-number="Please enter a number" id="Applicant2_DailySmokingAmount" max="99" maxlength="2" min="0" name="Applicant2.DailySmokingAmount"
oninput="this.value=this.value.slice(0,this.maxLength)" size="2" type="number" value="">
</div>
</div>
</div>
<div class="field-group field-group--indented yearsSinceSmoked" style="display: none;">
<label class="label--standard" for="Applicant2_YearsSinceSmoked">How many years ago did you quit smoking?</label>
<span id="err-YearsSinceSmoked-2" class="field-validation-error" style="display: none;">Enter how many years it's been since the policyholder quit smoking to the nearest year</span>
<span id="one-five-YearsSinceSmoked-2" class="field-validation-smoker" style="display: none;">Premium may increase if you have smoked in the last 1-5 years</span>
<div class="date-field">
<label for="Applicant2_YearsSinceSmoked">years</label>
<span class="field-validation-error" style="display: none;">This field cannot be blank</span>
<div>
<input class="number-input-width" data-val-number="Please enter a number" id="Applicant2_YearsSinceSmoked" max="99" maxlength="2" min="0" name="Applicant2.YearsSinceSmoked" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
</div>
</div>
<fieldset class="bordered-section AppAnswers App2Answers jointPolicySet section-1 hasqplus" id="Section_199_App2" iscomplete="False" style="display: none;">
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_0__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_issmoker-App2" class="AppAnswers App2Answers Answer11 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_0__ApplicantAnswerID" name="Applicant2.QuestionSet[0].ApplicantAnswerID" type="hidden" value="3269401">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_0__ApplicantId" name="Applicant2.QuestionSet[0].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_0__ApplicationId" name="Applicant2.QuestionSet[0].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_0__QuestionID" name="Applicant2.QuestionSet[0].QuestionID" type="hidden" value="11">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_0__ApplicantNumber" name="Applicant2.QuestionSet[0].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_0__SectionId" name="Applicant2.QuestionSet[0].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[0].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_0__AnswerValue" name="Applicant2.QuestionSet[0].AnswerValue" type="hidden" value="0">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_1__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-gender" class="AppAnswers App2Answers Answer1 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_1__ApplicantAnswerID" name="Applicant2.QuestionSet[1].ApplicantAnswerID" type="hidden" value="3269392">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_1__ApplicantId" name="Applicant2.QuestionSet[1].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_1__ApplicationId" name="Applicant2.QuestionSet[1].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_1__QuestionID" name="Applicant2.QuestionSet[1].QuestionID" type="hidden" value="1">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_1__ApplicantNumber" name="Applicant2.QuestionSet[1].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_1__SectionId" name="Applicant2.QuestionSet[1].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[1].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_1__AnswerValue" name="Applicant2.QuestionSet[1].AnswerValue" type="hidden" value="2">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_2__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-age" class="AppAnswers App2Answers Answer2 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_2__ApplicantAnswerID" name="Applicant2.QuestionSet[2].ApplicantAnswerID" type="hidden" value="3269393">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_2__ApplicantId" name="Applicant2.QuestionSet[2].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_2__ApplicationId" name="Applicant2.QuestionSet[2].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_2__QuestionID" name="Applicant2.QuestionSet[2].QuestionID" type="hidden" value="2">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_2__ApplicantNumber" name="Applicant2.QuestionSet[2].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_2__SectionId" name="Applicant2.QuestionSet[2].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[2].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_2__AnswerValue" name="Applicant2.QuestionSet[2].AnswerValue" type="hidden" value="0">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_3__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-sumassured" class="AppAnswers App2Answers Answer3 input-group">
<input id="Applicant2_QuestionSet_3__QuestionText" name="Applicant2.QuestionSet[3].QuestionText" type="hidden" value="SumAssured">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_3__ApplicantAnswerID" name="Applicant2.QuestionSet[3].ApplicantAnswerID" type="hidden" value="3269394">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_3__ApplicantId" name="Applicant2.QuestionSet[3].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_3__ApplicationId" name="Applicant2.QuestionSet[3].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_3__QuestionID" name="Applicant2.QuestionSet[3].QuestionID" type="hidden" value="3">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_3__ApplicantNumber" name="Applicant2.QuestionSet[3].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_3__SectionId" name="Applicant2.QuestionSet[3].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[3].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_3__AnswerValue" name="Applicant2.QuestionSet[3].AnswerValue" type="hidden" value="100000">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_4__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-term" class="AppAnswers App2Answers Answer4 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_4__ApplicantAnswerID" name="Applicant2.QuestionSet[4].ApplicantAnswerID" type="hidden" value="3269395">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_4__ApplicantId" name="Applicant2.QuestionSet[4].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_4__ApplicationId" name="Applicant2.QuestionSet[4].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_4__QuestionID" name="Applicant2.QuestionSet[4].QuestionID" type="hidden" value="4">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_4__ApplicantNumber" name="Applicant2.QuestionSet[4].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_4__SectionId" name="Applicant2.QuestionSet[4].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[4].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_4__AnswerValue" name="Applicant2.QuestionSet[4].AnswerValue" type="hidden" value="20">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_5__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-bmi" class="AppAnswers App2Answers Answer5 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_5__ApplicantAnswerID" name="Applicant2.QuestionSet[5].ApplicantAnswerID" type="hidden" value="3269396">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_5__ApplicantId" name="Applicant2.QuestionSet[5].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_5__ApplicationId" name="Applicant2.QuestionSet[5].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_5__QuestionID" name="Applicant2.QuestionSet[5].QuestionID" type="hidden" value="5">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_5__ApplicantNumber" name="Applicant2.QuestionSet[5].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_5__SectionId" name="Applicant2.QuestionSet[5].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[5].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_5__AnswerValue" name="Applicant2.QuestionSet[5].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant2_QuestionSet_6__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_height-App2" class="AppAnswers App2Answers Answer6 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_6__ApplicantAnswerID" name="Applicant2.QuestionSet[6].ApplicantAnswerID" type="hidden" value="3269397">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_6__ApplicantId" name="Applicant2.QuestionSet[6].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_6__ApplicationId" name="Applicant2.QuestionSet[6].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_6__QuestionID" name="Applicant2.QuestionSet[6].QuestionID" type="hidden" value="6">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_6__ApplicantNumber" name="Applicant2.QuestionSet[6].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_6__SectionId" name="Applicant2.QuestionSet[6].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App2Answers Answer6 qp_height" data-val="true" data-val-required="You must answer this question." id="Applicant2_QuestionSet_6__AnswerValue" name="Applicant2.QuestionSet[6].AnswerValue"
title="Please enter your height (without shoes)">
<option value="91.44">3ft 0ins</option>
<option value="93.98">3ft 1ins</option>
<option value="96.52">3ft 2ins</option>
<option value="99.06">3ft 3ins</option>
<option value="101.6">3ft 4ins</option>
<option value="104.14">3ft 5ins</option>
<option value="106.68">3ft 6ins</option>
<option value="109.22">3ft 7ins</option>
<option value="111.76">3ft 8ins</option>
<option value="114.3">3ft 9ins</option>
<option value="116.84">3ft 10ins</option>
<option value="119.38">3ft 11ins</option>
<option value="121.92">4ft 0ins</option>
<option value="124.46">4ft 1ins</option>
<option value="127">4ft 2ins</option>
<option value="129.54">4ft 3ins</option>
<option value="132.08">4ft 4ins</option>
<option value="134.62">4ft 5ins</option>
<option value="137.16">4ft 6ins</option>
<option value="139.7">4ft 7ins</option>
<option value="142.24">4ft 8ins</option>
<option value="144.78">4ft 9ins</option>
<option value="147.32">4ft 10ins</option>
<option value="149.86">4ft 11ins</option>
<option value="152.4">5ft 0ins</option>
<option value="154.94">5ft 1ins</option>
<option value="157.48">5ft 2ins</option>
<option value="160.02">5ft 3ins</option>
<option value="162.56">5ft 4ins</option>
<option value="165.1">5ft 5ins</option>
<option value="167.64">5ft 6ins</option>
<option value="170.18">5ft 7ins</option>
<option value="172.72">5ft 8ins</option>
<option value="175.26">5ft 9ins</option>
<option value="177.8">5ft 10ins</option>
<option value="180.34">5ft 11ins</option>
<option value="182.88">6ft 0ins</option>
<option value="185.42">6ft 1ins</option>
<option value="187.96">6ft 2ins</option>
<option value="190.5">6ft 3ins</option>
<option value="193.04">6ft 4ins</option>
<option value="195.58">6ft 5ins</option>
<option value="198.12">6ft 6ins</option>
<option value="200.66">6ft 7ins</option>
<option value="203.2">6ft 8ins</option>
<option value="205.74">6ft 9ins</option>
<option value="208.28">6ft 10ins</option>
<option value="210.82">6ft 11ins</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant2_QuestionSet_7__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_weight-App2" class="AppAnswers App2Answers Answer7 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_7__ApplicantAnswerID" name="Applicant2.QuestionSet[7].ApplicantAnswerID" type="hidden" value="3269398">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_7__ApplicantId" name="Applicant2.QuestionSet[7].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_7__ApplicationId" name="Applicant2.QuestionSet[7].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_7__QuestionID" name="Applicant2.QuestionSet[7].QuestionID" type="hidden" value="7">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_7__ApplicantNumber" name="Applicant2.QuestionSet[7].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_7__SectionId" name="Applicant2.QuestionSet[7].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App2Answers Answer7 qp_weight" data-val="true" data-val-required="You must answer this question." id="Applicant2_QuestionSet_7__AnswerValue" name="Applicant2.QuestionSet[7].AnswerValue"
title="Please enter your weight (wearing indoor clothes)">
<option value="31.75">5st 0lbs</option>
<option value="32.21">5st 1lbs</option>
<option value="32.66">5st 2lbs</option>
<option value="33.11">5st 3lbs</option>
<option value="33.57">5st 4lbs</option>
<option value="34.02">5st 5lbs</option>
<option value="34.47">5st 6lbs</option>
<option value="34.93">5st 7lbs</option>
<option value="35.38">5st 8lbs</option>
<option value="35.83">5st 9lbs</option>
<option value="36.29">5st 10lbs</option>
<option value="36.74">5st 11lbs</option>
<option value="37.19">5st 12lbs</option>
<option value="37.65">5st 13lbs</option>
<option value="38.10">6st 0lbs</option>
<option value="38.56">6st 1lbs</option>
<option value="39.01">6st 2lbs</option>
<option value="39.46">6st 3lbs</option>
<option value="39.92">6st 4lbs</option>
<option value="40.37">6st 5lbs</option>
<option value="40.82">6st 6lbs</option>
<option value="41.28">6st 7lbs</option>
<option value="41.73">6st 8lbs</option>
<option value="42.18">6st 9lbs</option>
<option value="42.64">6st 10lbs</option>
<option value="43.09">6st 11lbs</option>
<option value="43.54">6st 12lbs</option>
<option value="44.00">6st 13lbs</option>
<option value="44.45">7st 0lbs</option>
<option value="44.91">7st 1lbs</option>
<option value="45.36">7st 2lbs</option>
<option value="45.81">7st 3lbs</option>
<option value="46.27">7st 4lbs</option>
<option value="46.72">7st 5lbs</option>
<option value="47.17">7st 6lbs</option>
<option value="47.63">7st 7lbs</option>
<option value="48.08">7st 8lbs</option>
<option value="48.53">7st 9lbs</option>
<option value="48.99">7st 10lbs</option>
<option value="49.44">7st 11lbs</option>
<option value="49.90">7st 12lbs</option>
<option value="50.35">7st 13lbs</option>
<option value="50.80">8st 0lbs</option>
<option value="51.26">8st 1lbs</option>
<option value="51.71">8st 2lbs</option>
<option value="52.16">8st 3lbs</option>
<option value="52.62">8st 4lbs</option>
<option value="53.07">8st 5lbs</option>
<option value="53.52">8st 6lbs</option>
<option value="53.98">8st 7lbs</option>
<option value="54.43">8st 8lbs</option>
<option value="54.88">8st 9lbs</option>
<option value="55.34">8st 10lbs</option>
<option value="55.79">8st 11lbs</option>
<option value="56.25">8st 12lbs</option>
<option value="56.70">8st 13lbs</option>
<option value="57.15">9st 0lbs</option>
<option value="57.61">9st 1lbs</option>
<option value="58.06">9st 2lbs</option>
<option value="58.51">9st 3lbs</option>
<option value="58.97">9st 4lbs</option>
<option value="59.42">9st 5lbs</option>
<option value="59.87">9st 6lbs</option>
<option value="60.33">9st 7lbs</option>
<option value="60.78">9st 8lbs</option>
<option value="61.23">9st 9lbs</option>
<option value="61.69">9st 10lbs</option>
<option value="62.14">9st 11lbs</option>
<option value="62.60">9st 12lbs</option>
<option value="63.05">9st 13lbs</option>
<option value="63.50">10st 0lbs</option>
<option value="63.96">10st 1lbs</option>
<option value="64.41">10st 2lbs</option>
<option value="64.86">10st 3lbs</option>
<option value="65.32">10st 4lbs</option>
<option value="65.77">10st 5lbs</option>
<option value="66.22">10st 6lbs</option>
<option value="66.68">10st 7lbs</option>
<option value="67.13">10st 8lbs</option>
<option value="67.59">10st 9lbs</option>
<option value="68.04">10st 10lbs</option>
<option value="68.49">10st 11lbs</option>
<option value="68.95">10st 12lbs</option>
<option value="69.40">10st 13lbs</option>
<option value="69.85">11st 0lbs</option>
<option value="70.31">11st 1lbs</option>
<option value="70.76">11st 2lbs</option>
<option value="71.21">11st 3lbs</option>
<option value="71.67">11st 4lbs</option>
<option value="72.12">11st 5lbs</option>
<option value="72.57">11st 6lbs</option>
<option value="73.03">11st 7lbs</option>
<option value="73.48">11st 8lbs</option>
<option value="73.94">11st 9lbs</option>
<option value="74.39">11st 10lbs</option>
<option value="74.84">11st 11lbs</option>
<option value="75.30">11st 12lbs</option>
<option value="75.75">11st 13lbs</option>
<option value="76.20">12st 0lbs</option>
<option value="76.66">12st 1lbs</option>
<option value="77.11">12st 2lbs</option>
<option value="77.56">12st 3lbs</option>
<option value="78.02">12st 4lbs</option>
<option value="78.47">12st 5lbs</option>
<option value="78.93">12st 6lbs</option>
<option value="79.38">12st 7lbs</option>
<option value="79.83">12st 8lbs</option>
<option value="80.29">12st 9lbs</option>
<option value="80.74">12st 10lbs</option>
<option value="81.19">12st 11lbs</option>
<option value="81.65">12st 12lbs</option>
<option value="82.10">12st 13lbs</option>
<option value="82.55">13st 0lbs</option>
<option value="83.01">13st 1lbs</option>
<option value="83.46">13st 2lbs</option>
<option value="83.91">13st 3lbs</option>
<option value="84.37">13st 4lbs</option>
<option value="84.82">13st 5lbs</option>
<option value="85.28">13st 6lbs</option>
<option value="85.73">13st 7lbs</option>
<option value="86.18">13st 8lbs</option>
<option value="86.64">13st 9lbs</option>
<option value="87.09">13st 10lbs</option>
<option value="87.54">13st 11lbs</option>
<option value="88.00">13st 12lbs</option>
<option value="88.45">13st 13lbs</option>
<option value="88.90">14st 0lbs</option>
<option value="89.36">14st 1lbs</option>
<option value="89.81">14st 2lbs</option>
<option value="90.26">14st 3lbs</option>
<option value="90.72">14st 4lbs</option>
<option value="91.17">14st 5lbs</option>
<option value="91.63">14st 6lbs</option>
<option value="92.08">14st 7lbs</option>
<option value="92.53">14st 8lbs</option>
<option value="92.99">14st 9lbs</option>
<option value="93.44">14st 10lbs</option>
<option value="93.89">14st 11lbs</option>
<option value="94.35">14st 12lbs</option>
<option value="94.80">14st 13lbs</option>
<option value="95.25">15st 0lbs</option>
<option value="95.71">15st 1lbs</option>
<option value="96.16">15st 2lbs</option>
<option value="96.62">15st 3lbs</option>
<option value="97.07">15st 4lbs</option>
<option value="97.52">15st 5lbs</option>
<option value="97.98">15st 6lbs</option>
<option value="98.43">15st 7lbs</option>
<option value="98.88">15st 8lbs</option>
<option value="99.34">15st 9lbs</option>
<option value="99.79">15st 10lbs</option>
<option value="100.24">15st 11lbs</option>
<option value="100.70">15st 12lbs</option>
<option value="101.15">15st 13lbs</option>
<option value="101.60">16st 0lbs</option>
<option value="102.06">16st 1lbs</option>
<option value="102.51">16st 2lbs</option>
<option value="102.97">16st 3lbs</option>
<option value="103.42">16st 4lbs</option>
<option value="103.87">16st 5lbs</option>
<option value="104.33">16st 6lbs</option>
<option value="104.78">16st 7lbs</option>
<option value="105.23">16st 8lbs</option>
<option value="105.69">16st 9lbs</option>
<option value="106.14">16st 10lbs</option>
<option value="106.59">16st 11lbs</option>
<option value="107.05">16st 12lbs</option>
<option value="107.50">16st 13lbs</option>
<option value="107.95">17st 0lbs</option>
<option value="108.41">17st 1lbs</option>
<option value="108.86">17st 2lbs</option>
<option value="109.32">17st 3lbs</option>
<option value="109.77">17st 4lbs</option>
<option value="110.22">17st 5lbs</option>
<option value="110.68">17st 6lbs</option>
<option value="111.13">17st 7lbs</option>
<option value="111.58">17st 8lbs</option>
<option value="112.04">17st 9lbs</option>
<option value="112.49">17st 10lbs</option>
<option value="112.94">17st 11lbs</option>
<option value="113.40">17st 12lbs</option>
<option value="113.85">17st 13lbs</option>
<option value="114.31">18st 0lbs</option>
<option value="114.76">18st 1lbs</option>
<option value="115.21">18st 2lbs</option>
<option value="115.67">18st 3lbs</option>
<option value="116.12">18st 4lbs</option>
<option value="116.57">18st 5lbs</option>
<option value="117.03">18st 6lbs</option>
<option value="117.48">18st 7lbs</option>
<option value="117.93">18st 8lbs</option>
<option value="118.39">18st 9lbs</option>
<option value="118.84">18st 10lbs</option>
<option value="119.29">18st 11lbs</option>
<option value="119.75">18st 12lbs</option>
<option value="120.20">18st 13lbs</option>
<option value="120.66">19st 0lbs</option>
<option value="121.11">19st 1lbs</option>
<option value="121.56">19st 2lbs</option>
<option value="122.02">19st 3lbs</option>
<option value="122.47">19st 4lbs</option>
<option value="122.92">19st 5lbs</option>
<option value="123.38">19st 6lbs</option>
<option value="123.83">19st 7lbs</option>
<option value="124.28">19st 8lbs</option>
<option value="124.74">19st 9lbs</option>
<option value="125.19">19st 10lbs</option>
<option value="125.64">19st 11lbs</option>
<option value="126.10">19st 12lbs</option>
<option value="126.55">19st 13lbs</option>
<option value="127.01">20st 0lbs</option>
<option value="127.46">20st 1lbs</option>
<option value="127.91">20st 2lbs</option>
<option value="128.37">20st 3lbs</option>
<option value="128.82">20st 4lbs</option>
<option value="129.27">20st 5lbs</option>
<option value="129.73">20st 6lbs</option>
<option value="130.18">20st 7lbs</option>
<option value="130.63">20st 8lbs</option>
<option value="131.09">20st 9lbs</option>
<option value="131.54">20st 10lbs</option>
<option value="132.00">20st 11lbs</option>
<option value="132.45">20st 12lbs</option>
<option value="132.90">20st 13lbs</option>
<option value="133.36">21st 0lbs</option>
<option value="133.81">21st 1lbs</option>
<option value="134.26">21st 2lbs</option>
<option value="134.72">21st 3lbs</option>
<option value="135.17">21st 4lbs</option>
<option value="135.62">21st 5lbs</option>
<option value="136.08">21st 6lbs</option>
<option value="136.53">21st 7lbs</option>
<option value="136.98">21st 8lbs</option>
<option value="137.44">21st 9lbs</option>
<option value="137.89">21st 10lbs</option>
<option value="138.35">21st 11lbs</option>
<option value="138.80">21st 12lbs</option>
<option value="139.25">21st 13lbs</option>
<option value="139.71">22st 0lbs</option>
<option value="140.16">22st 1lbs</option>
<option value="140.61">22st 2lbs</option>
<option value="141.07">22st 3lbs</option>
<option value="141.52">22st 4lbs</option>
<option value="141.97">22st 5lbs</option>
<option value="142.43">22st 6lbs</option>
<option value="142.88">22st 7lbs</option>
<option value="143.34">22st 8lbs</option>
<option value="143.79">22st 9lbs</option>
<option value="144.24">22st 10lbs</option>
<option value="144.70">22st 11lbs</option>
<option value="145.15">22st 12lbs</option>
<option value="145.60">22st 13lbs</option>
<option value="146.06">23st 0lbs</option>
<option value="146.51">23st 1lbs</option>
<option value="146.96">23st 2lbs</option>
<option value="147.42">23st 3lbs</option>
<option value="147.87">23st 4lbs</option>
<option value="148.32">23st 5lbs</option>
<option value="148.78">23st 6lbs</option>
<option value="149.23">23st 7lbs</option>
<option value="149.69">23st 8lbs</option>
<option value="150.14">23st 9lbs</option>
<option value="150.59">23st 10lbs</option>
<option value="151.05">23st 11lbs</option>
<option value="151.50">23st 12lbs</option>
<option value="151.95">23st 13lbs</option>
<option value="152.41">24st 0lbs</option>
<option value="152.86">24st 1lbs</option>
<option value="153.31">24st 2lbs</option>
<option value="153.77">24st 3lbs</option>
<option value="154.22">24st 4lbs</option>
<option value="154.67">24st 5lbs</option>
<option value="155.13">24st 6lbs</option>
<option value="155.58">24st 7lbs</option>
<option value="156.04">24st 8lbs</option>
<option value="156.49">24st 9lbs</option>
<option value="156.94">24st 10lbs</option>
<option value="157.40">24st 11lbs</option>
<option value="157.85">24st 12lbs</option>
<option value="158.30">24st 13lbs</option>
<option value="158.80">25st 0lbs</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group form-row--with-tooltip display-none extra-questions "><label for="Applicant2_QuestionSet_8__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_smokinghistory-App2" class="AppAnswers App2Answers Answer8 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_8__ApplicantAnswerID" name="Applicant2.QuestionSet[8].ApplicantAnswerID" type="hidden" value="3269399">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_8__ApplicantId" name="Applicant2.QuestionSet[8].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_8__ApplicationId" name="Applicant2.QuestionSet[8].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_8__QuestionID" name="Applicant2.QuestionSet[8].QuestionID" type="hidden" value="8">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_8__ApplicantNumber" name="Applicant2.QuestionSet[8].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_8__SectionId" name="Applicant2.QuestionSet[8].SectionId" type="hidden" value="199">
<select class="standard-width AppAnswers App2Answers Answer8 qp_smokinghistory" data-val="true" data-val-required="You must answer this question." id="Applicant2_QuestionSet_8__AnswerValue" name="Applicant2.QuestionSet[8].AnswerValue"
title="Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes.">
<option selected="selected" value="0">Never smoked</option>
<option value="1">Have not smoked for at least 5 years</option>
<option value="2">Have not smoked for at least 12 months</option>
<option value="4">Up to 20 cigarettes per day within last year</option>
<option value="5">Up to 30 cigarettes per day within last year</option>
<option value="6">Up to 40 cigarettes per day within last year</option>
<option value="7">Up to 50 cigarettes per day within last year</option>
<option value="8">More than 50 cigarettes per day within last year</option>
</select>
</div>
</div>
<div style="display: block;" qp-data="" class="field-group display-none extra-questions "><label for="Applicant2_QuestionSet_9__AnswerValue role=" tooltip"="" class="label--standard"></label>
<div data-at="qp_2-alcohol" class="AppAnswers App2Answers Answer9 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_9__ApplicantAnswerID" name="Applicant2.QuestionSet[9].ApplicantAnswerID" type="hidden" value="3269400">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_9__ApplicantId" name="Applicant2.QuestionSet[9].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_9__ApplicationId" name="Applicant2.QuestionSet[9].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_9__QuestionID" name="Applicant2.QuestionSet[9].QuestionID" type="hidden" value="9">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_9__ApplicantNumber" name="Applicant2.QuestionSet[9].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_9__SectionId" name="Applicant2.QuestionSet[9].SectionId" type="hidden" value="199">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[9].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<input id="Applicant2_QuestionSet_9__AnswerValue" name="Applicant2.QuestionSet[9].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_10__AnswerValue role=" tooltip"="" class="label--standard">During a typical week, how many alcoholic drinks do you
have?</label>
<div role="tooltip">For example, a drink is a glass of wine or a glass or bottle of beer.</div>
<div data-at="qp_2-alcoholicdrinks" class=" Answer109 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_10__ApplicantAnswerID" name="Applicant2.QuestionSet[10].ApplicantAnswerID" type="hidden" value="3269411">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_10__ApplicantId" name="Applicant2.QuestionSet[10].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_10__ApplicationId" name="Applicant2.QuestionSet[10].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_10__QuestionID" name="Applicant2.QuestionSet[10].QuestionID" type="hidden" value="109">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_10__ApplicantNumber" name="Applicant2.QuestionSet[10].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_10__SectionId" name="Applicant2.QuestionSet[10].SectionId" type="hidden" value="199">
<label for="Applicant2_QuestionSet_10__AnswerValue" class="hidden-label"></label>
<span id="alcohol-2-1" style="display: none" class="field-validation-error">Enter the amount of drinks the policyholder normally has per week. Enter 0 if the policyholder doesn't drink</span>
<span id="alcohol-2-2" style="display: none" class="field-validation-error">This field must be a number.</span>
<span id="alcohol-2-3" style="display: none" class="field-validation-error">Units of Alcohol must be between 0 and 99.</span>
<div class="input-shell input-shell--option">
<div class="input-with-suffix modal-link modal-link--alcohol-calc">
<input class="Question109 OnlyNumbers number-input-width qp_alcoholicdrinks min alc2Sumtotal" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max=""
data-val-range-min="" id="Applicant2_QuestionSet_10__AnswerValue" max="99" maxlength="2" min="0" name="Applicant2.QuestionSet[10].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)" size="2" type="number" value="">
</div>
</div>
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App2Answers jointPolicySet section-2 hasqplus" id="Section_200_App2" iscomplete="False" style="display: none;">
<div style="" qp-data="TrouserQuestion" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_11__AnswerValue role=" tooltip"="" class="label--standard">What is your trouser size in UK inches?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-94-tooltip-trigger" type="checkbox"><label for="qp-2-94-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-94-tooltip" role="tooltip">
<p>Please use the size from the most recent clothing purchase you made for yourself.</p>
</div>
</div>
<div data-at="qp_2-trouser" class="AppAnswers App2Answers Answer94 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_11__ApplicantAnswerID" name="Applicant2.QuestionSet[11].ApplicantAnswerID" type="hidden" value="3269402">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_11__ApplicantId" name="Applicant2.QuestionSet[11].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_11__ApplicationId" name="Applicant2.QuestionSet[11].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_11__QuestionID" name="Applicant2.QuestionSet[11].QuestionID" type="hidden" value="94">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_11__ApplicantNumber" name="Applicant2.QuestionSet[11].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_11__SectionId" name="Applicant2.QuestionSet[11].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[11].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant2_QuestionSet_11__AnswerValue" class="hidden-label"></label>
<span id="Trouser-2-1" style="display: none" class="field-validation-error">The field must be a minimum of 2 digits</span>
<div class="input-shell input-shell--option">
<input class="Question94 TrouserQuestion qp_trouser" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max="" data-val-range-min=""
data-val-required="You must answer this question." id="Applicant2_QuestionSet_11__AnswerValue" max="9999999" maxlength="2" min="0" name="Applicant2.QuestionSet[11].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
<div style="" qp-data="SkirtQuestion" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_12__AnswerValue role=" tooltip"="" class="label--standard">What is your dress, skirt or trouser size?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-95-tooltip-trigger" type="checkbox"><label for="qp-2-95-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-95-tooltip" role="tooltip">
<p> Please use the size from the most recent clothing purchase you made for yourself. If you're pregnant, please advise your size prior to this pregnancy.</p>
</div>
</div>
<div data-at="qp_2-skirt" class="AppAnswers App2Answers Answer95 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_12__ApplicantAnswerID" name="Applicant2.QuestionSet[12].ApplicantAnswerID" type="hidden" value="3269403">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_12__ApplicantId" name="Applicant2.QuestionSet[12].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_12__ApplicationId" name="Applicant2.QuestionSet[12].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_12__QuestionID" name="Applicant2.QuestionSet[12].QuestionID" type="hidden" value="95">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_12__ApplicantNumber" name="Applicant2.QuestionSet[12].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_12__SectionId" name="Applicant2.QuestionSet[12].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[12].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant2_QuestionSet_12__AnswerValue" class="hidden-label"></label>
<div class="input-shell input-shell--option">
<input class="Question95 SkirtQuestion qp_skirt" data-val="true" data-val-number="The field must be a number." data-val-range="This value can only be between and " data-val-range-max="" data-val-range-min=""
data-val-required="You must answer this question." id="Applicant2_QuestionSet_12__AnswerValue" max="9999999" maxlength="2" min="0" name="Applicant2.QuestionSet[12].AnswerValue" oninput="this.value=this.value.slice(0,this.maxLength)"
size="2" type="number" value="">
</div>
</div>
</div>
<div style="" qp-data="Last2YearsMale-App2" class="field-group extra-questions "><label for="Applicant2_QuestionSet_13__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years, have you seen a health professional
about:</label>
<ul class="standard-list">
<li>a blood condition for example anaemia, blood clot? </li>
<li>a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? </li>
<li>a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? </li>
<li>any type of arthritis or gout? </li>
<li>a growth, lump, polyp or tumour? </li>
<li>anxiety, depression or any other type of mental illness? </li>
<li>any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have
fully recovered? </li>
</ul>
<div data-at="qp_2-anxiety-m" class="AppAnswers App2Answers Answer124 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_13__ApplicantAnswerID" name="Applicant2.QuestionSet[13].ApplicantAnswerID" type="hidden" value="3269418">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_13__ApplicantId" name="Applicant2.QuestionSet[13].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_13__ApplicationId" name="Applicant2.QuestionSet[13].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_13__QuestionID" name="Applicant2.QuestionSet[13].QuestionID" type="hidden" value="124">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_13__ApplicantNumber" name="Applicant2.QuestionSet[13].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_13__SectionId" name="Applicant2.QuestionSet[13].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[13].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_13__AnswerValue_1" value="1" name="Applicant2.QuestionSet[13].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_13__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_13__AnswerValue_0" value="0" name="Applicant2.QuestionSet[13].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_13__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_13__AnswerValue" name="Applicant2.QuestionSet[13].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last2YearsFemale-App2" class="field-group extra-questions "><label for="Applicant2_QuestionSet_14__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years, have you seen a health professional
about:</label>
<ul class="standard-list">
<li>a blood condition for example anaemia, blood clot? </li>
<li>a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? </li>
<li>a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? </li>
<li>any type of arthritis or gout? </li>
<li>a growth, lump, polyp or tumour? </li>
<li>anxiety, depression or any other type of mental illness? </li>
<li>any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have
fully recovered or pregnancy, contraceptive and infertility medication? </li>
</ul>
<div data-at="qp_2-anxiety-f" class="AppAnswers App2Answers Answer125 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_14__ApplicantAnswerID" name="Applicant2.QuestionSet[14].ApplicantAnswerID" type="hidden" value="3269419">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_14__ApplicantId" name="Applicant2.QuestionSet[14].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_14__ApplicationId" name="Applicant2.QuestionSet[14].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_14__QuestionID" name="Applicant2.QuestionSet[14].QuestionID" type="hidden" value="125">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_14__ApplicantNumber" name="Applicant2.QuestionSet[14].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_14__SectionId" name="Applicant2.QuestionSet[14].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[14].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_14__AnswerValue_1" value="1" name="Applicant2.QuestionSet[14].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_14__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_14__AnswerValue_0" value="0" name="Applicant2.QuestionSet[14].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_14__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_14__AnswerValue" name="Applicant2.QuestionSet[14].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_15__AnswerValue role=" tooltip"="" class="label--standard">Have any of your natural parents, brothers or sisters, before the age of 60, had any
of the following?</label>
<ul class="standard-list">
<li>Alzheimer's disease or dementia </li>
<li>Cancer of the bowel (colon), breast or ovary </li>
<li>Cardiomyopathy </li>
<li>Heart attack, diabetes or stroke </li>
<li>Huntington's disease </li>
<li>Motor neurone disease </li>
<li>Multiple sclerosis </li>
<li>Myotonic Dystrophy </li>
<li>Parkinson's disease </li>
<li>Polycystic kidney disease </li>
<li>Any other condition that runs in your family and that you're receiving regular follow up or screening for </li>
<li>Don't know</li>
</ul>
<div data-at="qp_2-familyhistory" class="AppAnswers App2Answers Answer118 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_15__ApplicantAnswerID" name="Applicant2.QuestionSet[15].ApplicantAnswerID" type="hidden" value="3269412">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_15__ApplicantId" name="Applicant2.QuestionSet[15].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_15__ApplicationId" name="Applicant2.QuestionSet[15].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_15__QuestionID" name="Applicant2.QuestionSet[15].QuestionID" type="hidden" value="118">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_15__ApplicantNumber" name="Applicant2.QuestionSet[15].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_15__SectionId" name="Applicant2.QuestionSet[15].SectionId" type="hidden" value="200">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[15].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_15__AnswerValue_1" value="1" name="Applicant2.QuestionSet[15].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_15__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_15__AnswerValue_0" value="0" name="Applicant2.QuestionSet[15].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_15__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_15__AnswerValue" name="Applicant2.QuestionSet[15].AnswerValue" type="hidden" value="">
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App2Answers jointPolicySet section-3 hasqplus" id="Section_201_App2" iscomplete="False" style="display: none;">
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_16__AnswerValue role=" tooltip"="" class="label--standard">Have you ever:</label>
<ul class="standard-list">
<li>had diabetes, excess sugar in the blood or a heart condition for example angina, heart attack, heart valve problem, heart surgery? </li>
<li>had a stroke, transient ischaemic attack (TIA) or a brain haemorrhage? </li>
<li>had cancer, Hodgkin's disease, Non-Hodgkin's lymphoma, leukaemia, a melanoma or a brain tumour? </li>
<li>had a neurological condition for example cerebral palsy, epilepsy, motor neurone disease, multiple sclerosis, muscular dystrophy, optic neuritis, paralysis, Parkinson's disease </li>
<li>been admitted overnight to hospital or referred to a psychiatrist for mental illness, anorexia or bulimia? </li>
<li>tested positive for HIV, or are you waiting for the result of an HIV test? </li>
</ul>
<div data-at="qp_2-diabetes" class="AppAnswers App2Answers Answer120 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_16__ApplicantAnswerID" name="Applicant2.QuestionSet[16].ApplicantAnswerID" type="hidden" value="3269414">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_16__ApplicantId" name="Applicant2.QuestionSet[16].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_16__ApplicationId" name="Applicant2.QuestionSet[16].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_16__QuestionID" name="Applicant2.QuestionSet[16].QuestionID" type="hidden" value="120">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_16__ApplicantNumber" name="Applicant2.QuestionSet[16].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_16__SectionId" name="Applicant2.QuestionSet[16].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[16].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_16__AnswerValue_1" value="1" name="Applicant2.QuestionSet[16].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_16__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_16__AnswerValue_0" value="0" name="Applicant2.QuestionSet[16].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_16__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_16__AnswerValue" name="Applicant2.QuestionSet[16].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last5YearsMale-App2" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_17__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years, have you seen a
health professional about:</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-122-tooltip-trigger" type="checkbox"><label for="qp-2-122-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-122-tooltip" role="tooltip">
<p>Please ignore birthmarks where no treatment or specialist referral has been advised.</p>
</div>
</div>
<ul class="standard-list">
<li>raised blood pressure? </li>
<li>raised cholesterol? </li>
<li>a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? </li>
<li>chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? </li>
<li>a mole or freckle? </li>
<li>any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? </li>
</ul>
<div data-at="qp_2-bloodpressure-m" class="AppAnswers App2Answers Answer122 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_17__ApplicantAnswerID" name="Applicant2.QuestionSet[17].ApplicantAnswerID" type="hidden" value="3269416">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_17__ApplicantId" name="Applicant2.QuestionSet[17].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_17__ApplicationId" name="Applicant2.QuestionSet[17].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_17__QuestionID" name="Applicant2.QuestionSet[17].QuestionID" type="hidden" value="122">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_17__ApplicantNumber" name="Applicant2.QuestionSet[17].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_17__SectionId" name="Applicant2.QuestionSet[17].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[17].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_17__AnswerValue_1" value="1" name="Applicant2.QuestionSet[17].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_17__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_17__AnswerValue_0" value="0" name="Applicant2.QuestionSet[17].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_17__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_17__AnswerValue" name="Applicant2.QuestionSet[17].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="Last5YearsFemale-App2" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_18__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years, have you seen a
health professional about:</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-123-tooltip-trigger" type="checkbox"><label for="qp-2-123-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-123-tooltip" role="tooltip">
<p>Please ignore routine cervical smears if the results have been normal. Please ignore birthmarks where no treatment or specialist referral has been advised.</p>
</div>
</div>
<ul class="standard-list">
<li>raised blood pressure? </li>
<li>raised cholesterol? </li>
<li>a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? </li>
<li>chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? </li>
<li>a mole or freckle? </li>
<li>any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? </li>
<li>any gynaecological condition for which you've not yet been discharged from follow up, or a cervical smear requiring further investigations? </li>
</ul>
<div data-at="qp_2-bloodpressure-f" class="AppAnswers App2Answers Answer123 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_18__ApplicantAnswerID" name="Applicant2.QuestionSet[18].ApplicantAnswerID" type="hidden" value="3269417">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_18__ApplicantId" name="Applicant2.QuestionSet[18].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_18__ApplicationId" name="Applicant2.QuestionSet[18].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_18__QuestionID" name="Applicant2.QuestionSet[18].QuestionID" type="hidden" value="123">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_18__ApplicantNumber" name="Applicant2.QuestionSet[18].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_18__SectionId" name="Applicant2.QuestionSet[18].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[18].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_18__AnswerValue_1" value="1" name="Applicant2.QuestionSet[18].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_18__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_18__AnswerValue_0" value="0" name="Applicant2.QuestionSet[18].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_18__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_18__AnswerValue" name="Applicant2.QuestionSet[18].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_19__AnswerValue role=" tooltip"="" class="label--standard">During the last 3 months, have you had:</label>
<ul class="standard-list">
<li>unexplained bleeding, weight loss, lump or growth? </li>
<li>breast or testicular changes of any sort? </li>
<li>a mole or freckle that has bled or changed in appearance or any other changes to your skin? </li>
<li>any other symptom for which you may see a health professional about for the first time? </li>
</ul>
<div data-at="qp_2-lastthreemonths" class="AppAnswers App2Answers Answer121 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_19__ApplicantAnswerID" name="Applicant2.QuestionSet[19].ApplicantAnswerID" type="hidden" value="3269415">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_19__ApplicantId" name="Applicant2.QuestionSet[19].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_19__ApplicationId" name="Applicant2.QuestionSet[19].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_19__QuestionID" name="Applicant2.QuestionSet[19].QuestionID" type="hidden" value="121">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_19__ApplicantNumber" name="Applicant2.QuestionSet[19].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_19__SectionId" name="Applicant2.QuestionSet[19].SectionId" type="hidden" value="201">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[19].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_19__AnswerValue_1" value="1" name="Applicant2.QuestionSet[19].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_19__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_19__AnswerValue_0" value="0" name="Applicant2.QuestionSet[19].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_19__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_19__AnswerValue" name="Applicant2.QuestionSet[19].AnswerValue" type="hidden" value="">
</div>
</div>
</fieldset>
<fieldset class="bordered-section AppAnswers App2Answers jointPolicySet section-4 hasqplus" id="Section_202_App2" iscomplete="False" style="display: none;">
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_20__AnswerValue role=" tooltip"="" class="label--standard">Do you regularly take part in any of the following activities
for work or recreation?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-104-tooltip-trigger" type="checkbox"><label for="qp-2-104-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-104-tooltip" role="tooltip">
<p>You can ignore one off parachute jumps</p>
</div>
</div>
<ul class="standard-list">
<li>Flying (other than as a fare-paying passenger) </li>
<li>Hang gliding or paragliding </li>
<li>Motor car or motorcycle sport </li>
<li>Mountaineering or rock climbing </li>
<li>Parachuting, sky diving or BASE jumping </li>
<li>Underwater diving </li>
<li>Any other extreme sport</li>
</ul>
<div data-at="qp_2-pastimes" class="AppAnswers App2Answers Answer104 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_20__ApplicantAnswerID" name="Applicant2.QuestionSet[20].ApplicantAnswerID" type="hidden" value="3269407">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_20__ApplicantId" name="Applicant2.QuestionSet[20].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_20__ApplicationId" name="Applicant2.QuestionSet[20].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_20__QuestionID" name="Applicant2.QuestionSet[20].QuestionID" type="hidden" value="104">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_20__ApplicantNumber" name="Applicant2.QuestionSet[20].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_20__SectionId" name="Applicant2.QuestionSet[20].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[20].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_20__AnswerValue_1" value="1" name="Applicant2.QuestionSet[20].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_20__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_20__AnswerValue_0" value="0" name="Applicant2.QuestionSet[20].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_20__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_20__AnswerValue" name="Applicant2.QuestionSet[20].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_21__AnswerValue role=" tooltip"="" class="label--standard">During the last 2 years have you spent more than 90 consecutive days in Africa, the
Caribbean, Russia, Thailand or Ukraine?</label>
<div data-at="qp_2-travelling" class="AppAnswers App2Answers Answer105 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_21__ApplicantAnswerID" name="Applicant2.QuestionSet[21].ApplicantAnswerID" type="hidden" value="3269408">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_21__ApplicantId" name="Applicant2.QuestionSet[21].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_21__ApplicationId" name="Applicant2.QuestionSet[21].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_21__QuestionID" name="Applicant2.QuestionSet[21].QuestionID" type="hidden" value="105">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_21__ApplicantNumber" name="Applicant2.QuestionSet[21].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_21__SectionId" name="Applicant2.QuestionSet[21].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[21].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_21__AnswerValue_1" value="1" name="Applicant2.QuestionSet[21].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_21__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_21__AnswerValue_0" value="0" name="Applicant2.QuestionSet[21].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_21__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_21__AnswerValue" name="Applicant2.QuestionSet[21].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_22__AnswerValue role=" tooltip"="" class="label--standard">During the next 2 years do you intend to spend more than 30
consecutive days outside the UK, EU, USA, Canada, Australia or New Zealand?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-106-tooltip-trigger" type="checkbox"><label for="qp-2-106-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-106-tooltip" role="tooltip">
<p>You can ignore travel as a member of the Armed Forces</p>
</div>
</div>
<div data-at="qp_2-moretravelling" class="AppAnswers App2Answers Answer106 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_22__ApplicantAnswerID" name="Applicant2.QuestionSet[22].ApplicantAnswerID" type="hidden" value="3269409">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_22__ApplicantId" name="Applicant2.QuestionSet[22].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_22__ApplicationId" name="Applicant2.QuestionSet[22].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_22__QuestionID" name="Applicant2.QuestionSet[22].QuestionID" type="hidden" value="106">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_22__ApplicantNumber" name="Applicant2.QuestionSet[22].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_22__SectionId" name="Applicant2.QuestionSet[22].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[22].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_22__AnswerValue_1" value="1" name="Applicant2.QuestionSet[22].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_22__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_22__AnswerValue_0" value="0" name="Applicant2.QuestionSet[22].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_22__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_22__AnswerValue" name="Applicant2.QuestionSet[22].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_23__AnswerValue role=" tooltip"="" class="label--standard">Do you work outside at heights over 15 metres (50ft), offshore in the oil, gas or
fishing industry, in the Armed Forces or as a member of the army reserve?</label>
<div data-at="qp_2-aboutyourjob" class="AppAnswers App2Answers Answer107 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_23__ApplicantAnswerID" name="Applicant2.QuestionSet[23].ApplicantAnswerID" type="hidden" value="3269410">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_23__ApplicantId" name="Applicant2.QuestionSet[23].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_23__ApplicationId" name="Applicant2.QuestionSet[23].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_23__QuestionID" name="Applicant2.QuestionSet[23].QuestionID" type="hidden" value="107">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_23__ApplicantNumber" name="Applicant2.QuestionSet[23].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_23__SectionId" name="Applicant2.QuestionSet[23].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[23].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_23__AnswerValue_1" value="1" name="Applicant2.QuestionSet[23].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_23__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_23__AnswerValue_0" value="0" name="Applicant2.QuestionSet[23].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_23__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_23__AnswerValue" name="Applicant2.QuestionSet[23].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_24__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years have you been disqualified from driving for a motoring offence
or convicted of careless or reckless driving?</label>
<div data-at="qp_2-driving" class="AppAnswers App2Answers Answer100 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_24__ApplicantAnswerID" name="Applicant2.QuestionSet[24].ApplicantAnswerID" type="hidden" value="3269404">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_24__ApplicantId" name="Applicant2.QuestionSet[24].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_24__ApplicationId" name="Applicant2.QuestionSet[24].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_24__QuestionID" name="Applicant2.QuestionSet[24].QuestionID" type="hidden" value="100">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_24__ApplicantNumber" name="Applicant2.QuestionSet[24].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_24__SectionId" name="Applicant2.QuestionSet[24].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[24].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_24__AnswerValue_1" value="1" name="Applicant2.QuestionSet[24].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_24__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_24__AnswerValue_0" value="0" name="Applicant2.QuestionSet[24].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_24__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_24__AnswerValue" name="Applicant2.QuestionSet[24].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_25__AnswerValue role=" tooltip"="" class="label--standard">During the last 5 years have you used any of the
following?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-102-tooltip-trigger" type="checkbox"><label for="qp-2-102-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-102-tooltip" role="tooltip">
<p>We'll only use the answer to this question to assess your application and at claim stage. Therefore there are no 'legal implications' in answering yes to this question.</p>
</div>
</div>
<ul class="standard-list">
<li>Recreational drugs, for example cocaine, ecstasy, heroin </li>
<li>Methadone </li>
<li>Anabolic steroids not prescribed by a doctor</li>
</ul>
<div data-at="qp_2-druguse" class="AppAnswers App2Answers Answer102 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_25__ApplicantAnswerID" name="Applicant2.QuestionSet[25].ApplicantAnswerID" type="hidden" value="3269405">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_25__ApplicantId" name="Applicant2.QuestionSet[25].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_25__ApplicationId" name="Applicant2.QuestionSet[25].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_25__QuestionID" name="Applicant2.QuestionSet[25].QuestionID" type="hidden" value="102">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_25__ApplicantNumber" name="Applicant2.QuestionSet[25].ApplicantNumber" type="hidden" value="2">
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<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_25__SectionId" name="Applicant2.QuestionSet[25].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[25].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_25__AnswerValue_1" value="1" name="Applicant2.QuestionSet[25].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_25__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_25__AnswerValue_0" value="0" name="Applicant2.QuestionSet[25].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_25__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_25__AnswerValue" name="Applicant2.QuestionSet[25].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group extra-questions "><label for="Applicant2_QuestionSet_26__AnswerValue role=" tooltip"="" class="label--standard">Have you ever been:</label>
<ul class="standard-list">
<li>told by a health professional that you should reduce the amount of alcohol you have because you were drinking too much? </li>
<li>seen by an alcohol specialist or attended an alcohol support group or been told that you have any liver damage? </li>
</ul>
<div data-at="qp_2-reducealcohol" class="AppAnswers App2Answers Answer103 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_26__ApplicantAnswerID" name="Applicant2.QuestionSet[26].ApplicantAnswerID" type="hidden" value="3269406">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_26__ApplicantId" name="Applicant2.QuestionSet[26].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_26__ApplicationId" name="Applicant2.QuestionSet[26].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_26__QuestionID" name="Applicant2.QuestionSet[26].QuestionID" type="hidden" value="103">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_26__ApplicantNumber" name="Applicant2.QuestionSet[26].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_26__SectionId" name="Applicant2.QuestionSet[26].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[26].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<div class="horizontal">
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_26__AnswerValue_1" value="1" name="Applicant2.QuestionSet[26].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_26__AnswerValue_1" class="replaced-input-label replaced-input-label--radio">Yes</label>
</div>
<div class="input-shell input-shell--option input-shell--horizontal qpradio">
<input type="radio" data-val="true" data-val-range-min="1" data-val-required="You must answer this question." id="Applicant2_QuestionSet_26__AnswerValue_0" value="0" name="Applicant2.QuestionSet[26].AnswerValue" class="replaced-input">
<label for="Applicant2_QuestionSet_26__AnswerValue_0" class="replaced-input-label replaced-input-label--radio">No</label>
</div>
</div>
<input id="Applicant2_QuestionSet_26__AnswerValue" name="Applicant2.QuestionSet[26].AnswerValue" type="hidden" value="">
</div>
</div>
<div style="" qp-data="" class="field-group form-row--with-tooltip extra-questions "><label for="Applicant2_QuestionSet_27__AnswerValue role=" tooltip"="" class="label--standard">Including this application, what is the total amount of life and
critical illness cover you will have?</label>
<div class="input-shell input-shell--tooltip"><input class="tooltip-trigger" id="qp-2-119-tooltip-trigger" type="checkbox"><label for="qp-2-119-tooltip-trigger"><span>More details</span></label>
<div id="qp-2-119-tooltip" role="tooltip">
<p>Please include any applications being made to another insurer but ignore cover that will be cancelled if this policy goes ahead.</p>
</div>
</div>
<div data-at="qp_2-totalcover" class="AppAnswers App2Answers Answer119 input-group">
<input data-val="true" data-val-required="The ApplicantAnswerID field is required." id="Applicant2_QuestionSet_27__ApplicantAnswerID" name="Applicant2.QuestionSet[27].ApplicantAnswerID" type="hidden" value="3269413">
<input data-val="true" data-val-required="The ApplicantId field is required." id="Applicant2_QuestionSet_27__ApplicantId" name="Applicant2.QuestionSet[27].ApplicantId" type="hidden" value="216830">
<input data-val="true" data-val-required="The ApplicationId field is required." id="Applicant2_QuestionSet_27__ApplicationId" name="Applicant2.QuestionSet[27].ApplicationId" type="hidden" value="157885">
<input data-val="true" data-val-required="The QuestionID field is required." id="Applicant2_QuestionSet_27__QuestionID" name="Applicant2.QuestionSet[27].QuestionID" type="hidden" value="119">
<input data-val="true" data-val-required="The ApplicantNumber field is required." id="Applicant2_QuestionSet_27__ApplicantNumber" name="Applicant2.QuestionSet[27].ApplicantNumber" type="hidden" value="2">
<!-- Include the section id so we can expand/collapse each secton on 'Next' -->
<input data-val="true" data-val-required="The SectionId field is required." id="Applicant2_QuestionSet_27__SectionId" name="Applicant2.QuestionSet[27].SectionId" type="hidden" value="202">
<div class="fld-msg qp-error ">
<span for="Applicant2.QuestionSet[27].AnswerValue" generated="true" class="field-validation-error qp-error" style="display: none;">You must answer this question.</span>
</div>
<label for="Applicant2_QuestionSet_27__AnswerValue" class="hidden-label"></label>
<span id="TotalAmount-2-1" style="display: none" class="field-validation-error">Total amount is required</span>
<span id="TotalAmount-2-2" style="display: none" class="field-validation-error">The field Amount of cover must be a number.</span>
<span id="TotalAmount-2-3" style="display: none" class="field-validation-error">Total amount must not be less than the sum assured.</span>
<div class="input-shell input-shell--prefixed">
<input class="js-life-calc-field standard-width qp_totalcover" id="Applicant2_QuestionSet_27__AnswerValue" max="9999999" maxlength="9" min="5000" name="Applicant2.QuestionSet[27].AnswerValue"
oninput="this.value=this.value.slice(0,this.maxLength)" size="10" step="1" type="number" value="">
</div>
</div>
</div>
</fieldset>
</div>
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.applicantEditText input {
float: right
}
</style>
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<input name="__RequestVerificationToken" type="hidden" value="CfDJ8OloiTI7g_5HmR5c9P-wJ-EEkE6j2a-I0Q5s49I5COw6OH2stx8UzqzzJbSrSpIzxrDNl_iXtityNJh8yipJTE8Ximo5BKaksHSB8B8ZiNhpjQjT5GvDS7XBXk-Hpz-EbSHw_f0QgfRUOQLM0W8BY44">
</form>Text Content
Call: 0800 098 2063 close Call for a quote: 0800 098 2063 Lines are open: Monday - Thursday: 9:30am - 8pm Friday: 9:30am - 1pm Calls to us are free but your phone company may apply an access charge. 1. Your details 1 of 4 2. Your quote 2 of 4 3. Apply online 3 of 4 4. Confirmation 4 of 4 We are searching for your life insurance quotes Contacting providers... It's important to answer questions truthfully, accurately and completely. If you don't, your policy could end up being amended, cancelled, or a claim not being paid. YOUR POLICY DETAILS THERE ARE ERRORS ON THIS PAGE THAT REQUIRE YOUR ATTENTION Skip to errors What do you need the insurance to protect? More on each cover type Mortgage insurance pays a sum of money that can be used to repay a mortgage or loan if you die during the term of the policy. Living costs insurance pays a guaranteed and fixed sum of money if you die during the term of the policy which can be used to provide for living expenses or any other purposes. Mortgage and living costs insurance pays a guaranteed and fixed sum of money if you die during the term of the policy. It can be used to repay a mortgage or loan and any other purposes, including future living expenses. Select insurance type Mortgage Living costs Mortgage and living costs What type of mortgage do you have? Mortgage types explained A capital repayment or 'decreasing' mortgage is where you pay off part of the mortage each month. The life insurance suited to this type of mortage would also reduce over the policy length. So as more of the mortgage is paid off, the less the policy would pay out if you were to die during the mortgage term. If this isn't the type of policy you need you can change on the results page. An interest-only or 'level' mortgage is when you only pay off the interest per month, so you'll still owe the full mortgage amount at the end of the term. The life cover suited for this is called level cover. Both the cover and premiums are fixed or 'level' from the date you start paying the until the end of the policy term. So if you die during the term, the full policy amount will be paid out. Mortgage Type is required Repayment (decreasing) Interest only (level) Select a payout option for your living costs You can always change your payout option on the quote result page. Living costs payout options explained Annual income is a family income benefit that covers your loved ones for the policy term. Once the term ends, the cover or any income payments stop. For example, if you have a 20 year policy and die 5 years into it, the policy will pay out a regular income for the remaining 15 years. If you die nearer the end of the policy term, the total payout will be less than if you died earlier in the term. Lump sum is a level term life insurance where the amount paid out if you die is fixed. If you died within the term of the policy, you'd get the full amount quoted. For example, a 20 year lump sum policy with a pay out of £150,000 would pay out this amount if you died during policy, no matter how far or short in to it. It provides certainty as both the cover and premiums are fixed from the date you start paying until the end of the policy term. Select payout option Annual Income Lump Sum How much cover do you need? Think about how much your family or dependants would still need were you to die. More details Things to think about when working out how much money to leave to your family or dependants are: * other financial commitments such as loans, overdrafts and credit cards * education costs * home living costs like bills, food, maintenance, home improvements * any sum you may want to leave your loved ones in the future Enter a value between £5,000 and £9,999,999 Enter amount of cover needed The field Amount of cover must be a number. Maximum value £100,000 Cover calculator Close Cover calculator How much of your mortgage is still outstanding? Enter a value up to £9,999,999. Do you have any other debts? Enter a value up to £9,999,999. What future plans might your family need help with? More details e.g. helping kids with Uni, your partner with a loan, etc. Enter a value up to £9,999,999. Will your family need help with funeral costs? More details The average cost of a UK funeral is £4,078 – SunLife Cost of Dying Report 2017 Enter a value up to £9,999,999. Other financial requirements Enter a value up to £9,999,999. Total life cover value: £0The total must be between £5,000 and £9,999,999. Use this total This is an illustration of the amount of life insurance you may need based on the information you've provided. It should not be taken as a recommendation or advice. How many years do you need your policy to last? Consider things like when your mortgage comes to an end, and when your family and dependants would become self sufficient. Help with working out policy length Things to think about to help work out your policy length: * If you only want cover for your mortgage, select how many years are left on your mortgage as your policy length * If you want to leave a lump sum as well as pay off your mortgage, think about who this money is going to and how much they'd need. As this is a financial safety net, consider how long your family or dependants would need to rely on this money before becoming self sufficient * You can also choose to have life insurance for a fixed period or the rest of your life Number of years must be between 5 and 40 Enter how many years you want cover for Who is the cover for? Policy types explained A single life policy insures just you. A joint life policy insures you and someone else. You and the other insured life must have a shared financial interest. For example, joint financial commitments such as mortgages, children or two friends with a joint mortgage. With a joint policy, if one of you die the cover is paid out but then the policy ends. If there are two lives to insure, both of you could have a single policy. Two single policies may be more expensive than a joint policy, but it means that if one policy is claimed against, the other policy will remain active. Just you You and someone else , ABOUT YOU (FIRST APPLICANT) Title We recognise not all titles are included here and so may not represent you as it should. Why isn't my title listed? For now these titles are what our system and insurance providers use. We're working to add in more inclusive titles. Select the policyholder's title Mr Mrs Ms Miss First name Enter the policyholder's first name Surname Enter the policyholder's surname Date of birth Enter the birth day, month and year as numbers Please select a valid date of birth. Day Month Year Postcode Please enter a valid UK postcode Email address We'll send you a confirmation email with your insurance quotes. Please enter a valid email address. Telephone number Providing your phone number is optional but will allow us to contact you to assist with your life insurance quotation. Providing your phone number is consent for us to contact you to offer assistance. Please enter a valid phone number What's your height? Select how you measure your height Select if you measure in centimetres or feet/inches Centimetres Feet/inches We need your height without shoes on Enter a height between 91.44 - 210.82 cm. If you're shorter or taller, call 0800 422 0060 for further help Enter a height between 3ft - 6ft 11. If you're shorter or taller, call 0800 422 0060 for further help Allowable range 3ft - 6ft 11 inches. If outside of this range, please call 0800 422 0060. Allowable range 92cm - 211cm. If outside of this range, please call 0800 422 0060. Feet Inches Centimetres What's your weight? Select how you measure your weight Select if you measure in kilograms or stones/pounds Kilograms Stone/pounds We need your weight to include wearing clothes Enter a weight between 31.75 - 153.23kg. If weight is outside this range, call 0800 422 0060 for further help Enter a weight between 5st - 24st 13lbs. If weight is outside this range, call 0800 422 0060 for further help Allowable range 5st - 24st 13lbs. If outside of this range, please call 0800 422 0060. Allowable range 32kg - 158kg. If outside of this range, please call 0800 422 0060. Stone Pounds Kilograms LIFESTYLE Do you smoke? If you've smoked in the last 12 months you're classed as a 'current smoker'. This includes cigars, pipes, e-cigarettes, nicotine replacements and regular cigarettes. How do you class smokers? Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes. Select if the policyholder has ever smoked Yes - current smoker Yes - ex-smoker No - never smoked When did you quit? If you've quit within last 12 months or used a nicotine replacement within this timeframe you're classed as a smoker. More details If you have smoked or used any tobacco products (including cigars, a pipe, cigarettes or nicotine replacement products) in the last 12 months then you are classified as a smoker. Less than 12 months ago More than 12 months ago On average, how many cigarettes or equivalent did you or do you smoke per day? Enter policyholder's average daily amount of cigarettes or equivalent Per day How many years ago did you quit smoking? Enter how many years it's been since the policyholder quit smoking to the nearest year Premium may increase if you have smoked in the last 1-5 years years This field cannot be blank You must answer this question. You must answer this question. You must answer this question. You must answer this question. You must answer this question. You must answer this question. 3ft 0ins 3ft 1ins 3ft 2ins 3ft 3ins 3ft 4ins 3ft 5ins 3ft 6ins 3ft 7ins 3ft 8ins 3ft 9ins 3ft 10ins 3ft 11ins 4ft 0ins 4ft 1ins 4ft 2ins 4ft 3ins 4ft 4ins 4ft 5ins 4ft 6ins 4ft 7ins 4ft 8ins 4ft 9ins 4ft 10ins 4ft 11ins 5ft 0ins 5ft 1ins 5ft 2ins 5ft 3ins 5ft 4ins 5ft 5ins 5ft 6ins 5ft 7ins 5ft 8ins 5ft 9ins 5ft 10ins 5ft 11ins 6ft 0ins 6ft 1ins 6ft 2ins 6ft 3ins 6ft 4ins 6ft 5ins 6ft 6ins 6ft 7ins 6ft 8ins 6ft 9ins 6ft 10ins 6ft 11ins 5st 0lbs 5st 1lbs 5st 2lbs 5st 3lbs 5st 4lbs 5st 5lbs 5st 6lbs 5st 7lbs 5st 8lbs 5st 9lbs 5st 10lbs 5st 11lbs 5st 12lbs 5st 13lbs 6st 0lbs 6st 1lbs 6st 2lbs 6st 3lbs 6st 4lbs 6st 5lbs 6st 6lbs 6st 7lbs 6st 8lbs 6st 9lbs 6st 10lbs 6st 11lbs 6st 12lbs 6st 13lbs 7st 0lbs 7st 1lbs 7st 2lbs 7st 3lbs 7st 4lbs 7st 5lbs 7st 6lbs 7st 7lbs 7st 8lbs 7st 9lbs 7st 10lbs 7st 11lbs 7st 12lbs 7st 13lbs 8st 0lbs 8st 1lbs 8st 2lbs 8st 3lbs 8st 4lbs 8st 5lbs 8st 6lbs 8st 7lbs 8st 8lbs 8st 9lbs 8st 10lbs 8st 11lbs 8st 12lbs 8st 13lbs 9st 0lbs 9st 1lbs 9st 2lbs 9st 3lbs 9st 4lbs 9st 5lbs 9st 6lbs 9st 7lbs 9st 8lbs 9st 9lbs 9st 10lbs 9st 11lbs 9st 12lbs 9st 13lbs 10st 0lbs 10st 1lbs 10st 2lbs 10st 3lbs 10st 4lbs 10st 5lbs 10st 6lbs 10st 7lbs 10st 8lbs 10st 9lbs 10st 10lbs 10st 11lbs 10st 12lbs 10st 13lbs 11st 0lbs 11st 1lbs 11st 2lbs 11st 3lbs 11st 4lbs 11st 5lbs 11st 6lbs 11st 7lbs 11st 8lbs 11st 9lbs 11st 10lbs 11st 11lbs 11st 12lbs 11st 13lbs 12st 0lbs 12st 1lbs 12st 2lbs 12st 3lbs 12st 4lbs 12st 5lbs 12st 6lbs 12st 7lbs 12st 8lbs 12st 9lbs 12st 10lbs 12st 11lbs 12st 12lbs 12st 13lbs 13st 0lbs 13st 1lbs 13st 2lbs 13st 3lbs 13st 4lbs 13st 5lbs 13st 6lbs 13st 7lbs 13st 8lbs 13st 9lbs 13st 10lbs 13st 11lbs 13st 12lbs 13st 13lbs 14st 0lbs 14st 1lbs 14st 2lbs 14st 3lbs 14st 4lbs 14st 5lbs 14st 6lbs 14st 7lbs 14st 8lbs 14st 9lbs 14st 10lbs 14st 11lbs 14st 12lbs 14st 13lbs 15st 0lbs 15st 1lbs 15st 2lbs 15st 3lbs 15st 4lbs 15st 5lbs 15st 6lbs 15st 7lbs 15st 8lbs 15st 9lbs 15st 10lbs 15st 11lbs 15st 12lbs 15st 13lbs 16st 0lbs 16st 1lbs 16st 2lbs 16st 3lbs 16st 4lbs 16st 5lbs 16st 6lbs 16st 7lbs 16st 8lbs 16st 9lbs 16st 10lbs 16st 11lbs 16st 12lbs 16st 13lbs 17st 0lbs 17st 1lbs 17st 2lbs 17st 3lbs 17st 4lbs 17st 5lbs 17st 6lbs 17st 7lbs 17st 8lbs 17st 9lbs 17st 10lbs 17st 11lbs 17st 12lbs 17st 13lbs 18st 0lbs 18st 1lbs 18st 2lbs 18st 3lbs 18st 4lbs 18st 5lbs 18st 6lbs 18st 7lbs 18st 8lbs 18st 9lbs 18st 10lbs 18st 11lbs 18st 12lbs 18st 13lbs 19st 0lbs 19st 1lbs 19st 2lbs 19st 3lbs 19st 4lbs 19st 5lbs 19st 6lbs 19st 7lbs 19st 8lbs 19st 9lbs 19st 10lbs 19st 11lbs 19st 12lbs 19st 13lbs 20st 0lbs 20st 1lbs 20st 2lbs 20st 3lbs 20st 4lbs 20st 5lbs 20st 6lbs 20st 7lbs 20st 8lbs 20st 9lbs 20st 10lbs 20st 11lbs 20st 12lbs 20st 13lbs 21st 0lbs 21st 1lbs 21st 2lbs 21st 3lbs 21st 4lbs 21st 5lbs 21st 6lbs 21st 7lbs 21st 8lbs 21st 9lbs 21st 10lbs 21st 11lbs 21st 12lbs 21st 13lbs 22st 0lbs 22st 1lbs 22st 2lbs 22st 3lbs 22st 4lbs 22st 5lbs 22st 6lbs 22st 7lbs 22st 8lbs 22st 9lbs 22st 10lbs 22st 11lbs 22st 12lbs 22st 13lbs 23st 0lbs 23st 1lbs 23st 2lbs 23st 3lbs 23st 4lbs 23st 5lbs 23st 6lbs 23st 7lbs 23st 8lbs 23st 9lbs 23st 10lbs 23st 11lbs 23st 12lbs 23st 13lbs 24st 0lbs 24st 1lbs 24st 2lbs 24st 3lbs 24st 4lbs 24st 5lbs 24st 6lbs 24st 7lbs 24st 8lbs 24st 9lbs 24st 10lbs 24st 11lbs 24st 12lbs 24st 13lbs 25st 0lbs Never smoked Have not smoked for at least 5 years Have not smoked for at least 12 months Up to 20 cigarettes per day within last year Up to 30 cigarettes per day within last year Up to 40 cigarettes per day within last year Up to 50 cigarettes per day within last year More than 50 cigarettes per day within last year You must answer this question. During a typical week, how many alcoholic drinks do you have? For example, a drink is a glass of wine or a glass or bottle of beer. Enter the amount of drinks the policyholder normally has per week. Enter 0 if the policyholder doesn't drink This field must be a number. Units of Alcohol must be between 0 and 99. What is your trouser size in UK inches? More details Please use the size from the most recent clothing purchase you made for yourself. You must answer this question. The field must be a minimum of 2 digits What is your dress, skirt or trouser size? More details Please use the size from the most recent clothing purchase you made for yourself. If you're pregnant, please advise your size prior to this pregnancy. You must answer this question. During the last 2 years, have you seen a health professional about: * a blood condition for example anaemia, blood clot? * a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? * a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? * any type of arthritis or gout? * a growth, lump, polyp or tumour? * anxiety, depression or any other type of mental illness? * any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have fully recovered? You must answer this question. Yes No During the last 2 years, have you seen a health professional about: * a blood condition for example anaemia, blood clot? * a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? * a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? * any type of arthritis or gout? * a growth, lump, polyp or tumour? * anxiety, depression or any other type of mental illness? * any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have fully recovered or pregnancy, contraceptive and infertility medication? You must answer this question. Yes No Have any of your natural parents, brothers or sisters, before the age of 60, had any of the following? * Alzheimer's disease or dementia * Cancer of the bowel (colon), breast or ovary * Cardiomyopathy * Heart attack, diabetes or stroke * Huntington's disease * Motor neurone disease * Multiple sclerosis * Myotonic Dystrophy * Parkinson's disease * Polycystic kidney disease * Any other condition that runs in your family and that you're receiving regular follow up or screening for * Don't know You must answer this question. Yes No Have you ever: * had diabetes, excess sugar in the blood or a heart condition for example angina, heart attack, heart valve problem, heart surgery? * had a stroke, transient ischaemic attack (TIA) or a brain haemorrhage? * had cancer, Hodgkin's disease, Non-Hodgkin's lymphoma, leukaemia, a melanoma or a brain tumour? * had a neurological condition for example cerebral palsy, epilepsy, motor neurone disease, multiple sclerosis, muscular dystrophy, optic neuritis, paralysis, Parkinson's disease * been admitted overnight to hospital or referred to a psychiatrist for mental illness, anorexia or bulimia? * tested positive for HIV, or are you waiting for the result of an HIV test? You must answer this question. Yes No During the last 5 years, have you seen a health professional about: More details Please ignore birthmarks where no treatment or specialist referral has been advised. * raised blood pressure? * raised cholesterol? * a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? * chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? * a mole or freckle? * any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? You must answer this question. Yes No During the last 5 years, have you seen a health professional about: More details Please ignore routine cervical smears if the results have been normal. Please ignore birthmarks where no treatment or specialist referral has been advised. * raised blood pressure? * raised cholesterol? * a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? * chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? * a mole or freckle? * any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? * any gynaecological condition for which you've not yet been discharged from follow up, or a cervical smear requiring further investigations? You must answer this question. Yes No During the last 3 months, have you had: * unexplained bleeding, weight loss, lump or growth? * breast or testicular changes of any sort? * a mole or freckle that has bled or changed in appearance or any other changes to your skin? * any other symptom for which you may see a health professional about for the first time? You must answer this question. Yes No Do you regularly take part in any of the following activities for work or recreation? More details You can ignore one off parachute jumps * Flying (other than as a fare-paying passenger) * Hang gliding or paragliding * Motor car or motorcycle sport * Mountaineering or rock climbing * Parachuting, sky diving or BASE jumping * Underwater diving * Any other extreme sport You must answer this question. Yes No During the last 2 years have you spent more than 90 consecutive days in Africa, the Caribbean, Russia, Thailand or Ukraine? You must answer this question. Yes No During the next 2 years do you intend to spend more than 30 consecutive days outside the UK, EU, USA, Canada, Australia or New Zealand? More details You can ignore travel as a member of the Armed Forces You must answer this question. Yes No Do you work outside at heights over 15 metres (50ft), offshore in the oil, gas or fishing industry, in the Armed Forces or as a member of the army reserve? You must answer this question. Yes No During the last 5 years have you been disqualified from driving for a motoring offence or convicted of careless or reckless driving? You must answer this question. Yes No During the last 5 years have you used any of the following? More details We'll only use the answer to this question to assess your application and at claim stage. Therefore there are no 'legal implications' in answering yes to this question. * Recreational drugs, for example cocaine, ecstasy, heroin * Methadone * Anabolic steroids not prescribed by a doctor You must answer this question. Yes No Have you ever been: * told by a health professional that you should reduce the amount of alcohol you have because you were drinking too much? * seen by an alcohol specialist or attended an alcohol support group or been told that you have any liver damage? You must answer this question. Yes No Including this application, what is the total amount of life and critical illness cover you will have? More details Please include any applications being made to another insurer but ignore cover that will be cancelled if this policy goes ahead. You must answer this question. Total amount is required The field Amount of cover must be a number. Total amount must not be less than the sum assured. Tick the box to continue getting a quote. For more information on Direct Life and Pension Services, see their privacy policy. I consent to Money processing my personal data to provide a life insurance service and sharing data with money.co.uk and quoting Insurers. I have read and accept both DLPS privacy policy and that of Money.co.uk's privacy policy and terms and conditions and understand that I can withdraw consent at any time. , ABOUT OTHER APPLICANT Title We recognise not all titles are included here and so may not represent you as it should. Why isn't my title listed? For now these titles are what our system and insurance providers use. We're working to add in more inclusive titles. Select the policyholder's title Mr Mrs Ms Miss First name Enter the policyholder's first name Surname Enter the policyholder's surname Date of birth Enter the birth day, month and year as numbers Please select a valid date of birth. Day Month Year Postcode Please enter a valid UK postcode What's your height? Select how you measure your height Select if you measure in centimetres or feet/inches Centimetres Feet/inches We need your height without shoes on Enter a height between 91.44 - 210.82 cm. If you're shorter or taller, call 0800 422 0060 for further help Enter a height between 3ft - 6ft 11. If you're shorter or taller, call 0800 422 0060 for further help Allowable range 3ft - 6ft 11 inches. If outside of this range, please call 0800 422 0060. Allowable range 92cm - 211cm. If outside of this range, please call 0800 422 0060. Feet Inches Centimetres What's your weight? Select how you measure your weight Select if you measure in kilograms or stones/pounds Kilograms Stone/pounds We need your weight to include wearing clothes Enter a weight between 31.75 - 153.23kg. If weight is outside this range, call 0800 422 0060 for further help Enter a weight between 5st - 24st 13lbs. If weight is outside this range, call 0800 422 0060 for further help Allowable range 5st - 24st 13lbs. If outside of this range, please call 0800 422 0060. Allowable range 32kg - 158kg. If outside of this range, please call 0800 422 0060. Stone Pounds Kilograms LIFESTYLE Do you smoke? If you've smoked in the last 12 months you're classed as a 'current smoker'. This includes cigars, pipes, e-cigarettes, nicotine replacements and regular cigarettes. How do you class smokers? Please select the option from the list that reflects your smoking history. A smoker is someone who smokes cigarettes or cigars / uses a pipe or other tobacco product / uses nicotine replacement products including e-cigarettes. Select if the policyholder has ever smoked Yes - current smoker Yes - ex-smoker No - never smoked When did you quit? If you've quit within last 12 months or used a nicotine replacement within this timeframe you're classed as a smoker. More details If you have smoked or used any tobacco products (including cigars, a pipe, cigarettes or nicotine replacement products) in the last 12 months then you are classified as a smoker. Less than 12 months ago More than 12 months ago On average, how many cigarettes or equivalent did you or do you smoke per day? Enter policyholder's average daily amount of cigarettes or equivalent Per day How many years ago did you quit smoking? Enter how many years it's been since the policyholder quit smoking to the nearest year Premium may increase if you have smoked in the last 1-5 years years This field cannot be blank You must answer this question. You must answer this question. You must answer this question. You must answer this question. You must answer this question. You must answer this question. 3ft 0ins 3ft 1ins 3ft 2ins 3ft 3ins 3ft 4ins 3ft 5ins 3ft 6ins 3ft 7ins 3ft 8ins 3ft 9ins 3ft 10ins 3ft 11ins 4ft 0ins 4ft 1ins 4ft 2ins 4ft 3ins 4ft 4ins 4ft 5ins 4ft 6ins 4ft 7ins 4ft 8ins 4ft 9ins 4ft 10ins 4ft 11ins 5ft 0ins 5ft 1ins 5ft 2ins 5ft 3ins 5ft 4ins 5ft 5ins 5ft 6ins 5ft 7ins 5ft 8ins 5ft 9ins 5ft 10ins 5ft 11ins 6ft 0ins 6ft 1ins 6ft 2ins 6ft 3ins 6ft 4ins 6ft 5ins 6ft 6ins 6ft 7ins 6ft 8ins 6ft 9ins 6ft 10ins 6ft 11ins 5st 0lbs 5st 1lbs 5st 2lbs 5st 3lbs 5st 4lbs 5st 5lbs 5st 6lbs 5st 7lbs 5st 8lbs 5st 9lbs 5st 10lbs 5st 11lbs 5st 12lbs 5st 13lbs 6st 0lbs 6st 1lbs 6st 2lbs 6st 3lbs 6st 4lbs 6st 5lbs 6st 6lbs 6st 7lbs 6st 8lbs 6st 9lbs 6st 10lbs 6st 11lbs 6st 12lbs 6st 13lbs 7st 0lbs 7st 1lbs 7st 2lbs 7st 3lbs 7st 4lbs 7st 5lbs 7st 6lbs 7st 7lbs 7st 8lbs 7st 9lbs 7st 10lbs 7st 11lbs 7st 12lbs 7st 13lbs 8st 0lbs 8st 1lbs 8st 2lbs 8st 3lbs 8st 4lbs 8st 5lbs 8st 6lbs 8st 7lbs 8st 8lbs 8st 9lbs 8st 10lbs 8st 11lbs 8st 12lbs 8st 13lbs 9st 0lbs 9st 1lbs 9st 2lbs 9st 3lbs 9st 4lbs 9st 5lbs 9st 6lbs 9st 7lbs 9st 8lbs 9st 9lbs 9st 10lbs 9st 11lbs 9st 12lbs 9st 13lbs 10st 0lbs 10st 1lbs 10st 2lbs 10st 3lbs 10st 4lbs 10st 5lbs 10st 6lbs 10st 7lbs 10st 8lbs 10st 9lbs 10st 10lbs 10st 11lbs 10st 12lbs 10st 13lbs 11st 0lbs 11st 1lbs 11st 2lbs 11st 3lbs 11st 4lbs 11st 5lbs 11st 6lbs 11st 7lbs 11st 8lbs 11st 9lbs 11st 10lbs 11st 11lbs 11st 12lbs 11st 13lbs 12st 0lbs 12st 1lbs 12st 2lbs 12st 3lbs 12st 4lbs 12st 5lbs 12st 6lbs 12st 7lbs 12st 8lbs 12st 9lbs 12st 10lbs 12st 11lbs 12st 12lbs 12st 13lbs 13st 0lbs 13st 1lbs 13st 2lbs 13st 3lbs 13st 4lbs 13st 5lbs 13st 6lbs 13st 7lbs 13st 8lbs 13st 9lbs 13st 10lbs 13st 11lbs 13st 12lbs 13st 13lbs 14st 0lbs 14st 1lbs 14st 2lbs 14st 3lbs 14st 4lbs 14st 5lbs 14st 6lbs 14st 7lbs 14st 8lbs 14st 9lbs 14st 10lbs 14st 11lbs 14st 12lbs 14st 13lbs 15st 0lbs 15st 1lbs 15st 2lbs 15st 3lbs 15st 4lbs 15st 5lbs 15st 6lbs 15st 7lbs 15st 8lbs 15st 9lbs 15st 10lbs 15st 11lbs 15st 12lbs 15st 13lbs 16st 0lbs 16st 1lbs 16st 2lbs 16st 3lbs 16st 4lbs 16st 5lbs 16st 6lbs 16st 7lbs 16st 8lbs 16st 9lbs 16st 10lbs 16st 11lbs 16st 12lbs 16st 13lbs 17st 0lbs 17st 1lbs 17st 2lbs 17st 3lbs 17st 4lbs 17st 5lbs 17st 6lbs 17st 7lbs 17st 8lbs 17st 9lbs 17st 10lbs 17st 11lbs 17st 12lbs 17st 13lbs 18st 0lbs 18st 1lbs 18st 2lbs 18st 3lbs 18st 4lbs 18st 5lbs 18st 6lbs 18st 7lbs 18st 8lbs 18st 9lbs 18st 10lbs 18st 11lbs 18st 12lbs 18st 13lbs 19st 0lbs 19st 1lbs 19st 2lbs 19st 3lbs 19st 4lbs 19st 5lbs 19st 6lbs 19st 7lbs 19st 8lbs 19st 9lbs 19st 10lbs 19st 11lbs 19st 12lbs 19st 13lbs 20st 0lbs 20st 1lbs 20st 2lbs 20st 3lbs 20st 4lbs 20st 5lbs 20st 6lbs 20st 7lbs 20st 8lbs 20st 9lbs 20st 10lbs 20st 11lbs 20st 12lbs 20st 13lbs 21st 0lbs 21st 1lbs 21st 2lbs 21st 3lbs 21st 4lbs 21st 5lbs 21st 6lbs 21st 7lbs 21st 8lbs 21st 9lbs 21st 10lbs 21st 11lbs 21st 12lbs 21st 13lbs 22st 0lbs 22st 1lbs 22st 2lbs 22st 3lbs 22st 4lbs 22st 5lbs 22st 6lbs 22st 7lbs 22st 8lbs 22st 9lbs 22st 10lbs 22st 11lbs 22st 12lbs 22st 13lbs 23st 0lbs 23st 1lbs 23st 2lbs 23st 3lbs 23st 4lbs 23st 5lbs 23st 6lbs 23st 7lbs 23st 8lbs 23st 9lbs 23st 10lbs 23st 11lbs 23st 12lbs 23st 13lbs 24st 0lbs 24st 1lbs 24st 2lbs 24st 3lbs 24st 4lbs 24st 5lbs 24st 6lbs 24st 7lbs 24st 8lbs 24st 9lbs 24st 10lbs 24st 11lbs 24st 12lbs 24st 13lbs 25st 0lbs Never smoked Have not smoked for at least 5 years Have not smoked for at least 12 months Up to 20 cigarettes per day within last year Up to 30 cigarettes per day within last year Up to 40 cigarettes per day within last year Up to 50 cigarettes per day within last year More than 50 cigarettes per day within last year You must answer this question. During a typical week, how many alcoholic drinks do you have? For example, a drink is a glass of wine or a glass or bottle of beer. Enter the amount of drinks the policyholder normally has per week. Enter 0 if the policyholder doesn't drink This field must be a number. Units of Alcohol must be between 0 and 99. What is your trouser size in UK inches? More details Please use the size from the most recent clothing purchase you made for yourself. You must answer this question. The field must be a minimum of 2 digits What is your dress, skirt or trouser size? More details Please use the size from the most recent clothing purchase you made for yourself. If you're pregnant, please advise your size prior to this pregnancy. You must answer this question. During the last 2 years, have you seen a health professional about: * a blood condition for example anaemia, blood clot? * a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? * a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? * any type of arthritis or gout? * a growth, lump, polyp or tumour? * anxiety, depression or any other type of mental illness? * any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have fully recovered? You must answer this question. Yes No During the last 2 years, have you seen a health professional about: * a blood condition for example anaemia, blood clot? * a lung or breathing condition for example asthma, bronchitis, chronic obstructive lung disease, emphysema. Please ignore hay fever and isolated chest infections from which you have fully recovered? * a condition affecting your stomach, bowel or oesophagus for example Crohn's disease, ulcerative colitis. Please ignore diarrhoea, food poisoning, sickness or vomiting, stomach bug or upset provided you have fully recovered? * any type of arthritis or gout? * a growth, lump, polyp or tumour? * anxiety, depression or any other type of mental illness? * any other condition for which you are required to attend review or follow-up, including medication review, or a condition for which you have been admitted overnight to hospital. Please ignore accidents and injuries from which you have fully recovered or pregnancy, contraceptive and infertility medication? You must answer this question. Yes No Have any of your natural parents, brothers or sisters, before the age of 60, had any of the following? * Alzheimer's disease or dementia * Cancer of the bowel (colon), breast or ovary * Cardiomyopathy * Heart attack, diabetes or stroke * Huntington's disease * Motor neurone disease * Multiple sclerosis * Myotonic Dystrophy * Parkinson's disease * Polycystic kidney disease * Any other condition that runs in your family and that you're receiving regular follow up or screening for * Don't know You must answer this question. Yes No Have you ever: * had diabetes, excess sugar in the blood or a heart condition for example angina, heart attack, heart valve problem, heart surgery? * had a stroke, transient ischaemic attack (TIA) or a brain haemorrhage? * had cancer, Hodgkin's disease, Non-Hodgkin's lymphoma, leukaemia, a melanoma or a brain tumour? * had a neurological condition for example cerebral palsy, epilepsy, motor neurone disease, multiple sclerosis, muscular dystrophy, optic neuritis, paralysis, Parkinson's disease * been admitted overnight to hospital or referred to a psychiatrist for mental illness, anorexia or bulimia? * tested positive for HIV, or are you waiting for the result of an HIV test? You must answer this question. Yes No During the last 5 years, have you seen a health professional about: More details Please ignore birthmarks where no treatment or specialist referral has been advised. * raised blood pressure? * raised cholesterol? * a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? * chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? * a mole or freckle? * any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? You must answer this question. Yes No During the last 5 years, have you seen a health professional about: More details Please ignore routine cervical smears if the results have been normal. Please ignore birthmarks where no treatment or specialist referral has been advised. * raised blood pressure? * raised cholesterol? * a condition affecting your kidney, bladder, liver or pancreas for example kidney stones, hepatitis, fatty liver? * chest pain, palpitations or irregular heartbeat, numbness, persistent tingling or pins and needles, memory loss, dizziness, balance problems, lupus, tremor or facial pain other than dental pain? * a mole or freckle? * any condition affecting your ears or hearing (for example Meniere's disease or deafness), or eyes or vision not wholly corrected by spectacles, lenses or laser treatment, (for example cataract, blindness)? * any gynaecological condition for which you've not yet been discharged from follow up, or a cervical smear requiring further investigations? You must answer this question. Yes No During the last 3 months, have you had: * unexplained bleeding, weight loss, lump or growth? * breast or testicular changes of any sort? * a mole or freckle that has bled or changed in appearance or any other changes to your skin? * any other symptom for which you may see a health professional about for the first time? You must answer this question. Yes No Do you regularly take part in any of the following activities for work or recreation? More details You can ignore one off parachute jumps * Flying (other than as a fare-paying passenger) * Hang gliding or paragliding * Motor car or motorcycle sport * Mountaineering or rock climbing * Parachuting, sky diving or BASE jumping * Underwater diving * Any other extreme sport You must answer this question. Yes No During the last 2 years have you spent more than 90 consecutive days in Africa, the Caribbean, Russia, Thailand or Ukraine? You must answer this question. Yes No During the next 2 years do you intend to spend more than 30 consecutive days outside the UK, EU, USA, Canada, Australia or New Zealand? More details You can ignore travel as a member of the Armed Forces You must answer this question. Yes No Do you work outside at heights over 15 metres (50ft), offshore in the oil, gas or fishing industry, in the Armed Forces or as a member of the army reserve? You must answer this question. Yes No During the last 5 years have you been disqualified from driving for a motoring offence or convicted of careless or reckless driving? You must answer this question. Yes No During the last 5 years have you used any of the following? More details We'll only use the answer to this question to assess your application and at claim stage. Therefore there are no 'legal implications' in answering yes to this question. * Recreational drugs, for example cocaine, ecstasy, heroin * Methadone * Anabolic steroids not prescribed by a doctor You must answer this question. Yes No Have you ever been: * told by a health professional that you should reduce the amount of alcohol you have because you were drinking too much? * seen by an alcohol specialist or attended an alcohol support group or been told that you have any liver damage? You must answer this question. Yes No Including this application, what is the total amount of life and critical illness cover you will have? More details Please include any applications being made to another insurer but ignore cover that will be cancelled if this policy goes ahead. You must answer this question. Total amount is required The field Amount of cover must be a number. Total amount must not be less than the sum assured. That's great - we've got everything we need. Get your quote! Get a quote Continue Our terms & conditions, privacy policy, accessibility and complaints procedure Money.co.uk is a trading name of Dot Zinc Limited, registered in England (4093922) and authorised and regulated by the Financial Conduct Authority (415689). Our registered address is: The Cooperage, 5 Copper Row, London, England, SE1 2LH. Money Life is arranged and administered by Direct Life & Pension Services Ltd, who are authorised and regulated by the Financial Conduct Authority. Registered office: Howard House, 3 St Mary's Court, Blossom Street, York, United Kingdom, YO24 1AH. Registered in England and Wales No 2467691 and VAT number 842795983. © Copyright 2024 Money.co.uk. All rights reserved.