A Declaration of Health (DOH) is required, before a policy can be reinstated, if it has been more than 60 days since an unpaid premium was received.

You will receive a letter notifying you that your Direct Debit is currently stopped along with the total arrears outstanding on your policy.

With the letter you will also find a New Direct Debit Instruction and a Declaration of Health (Reinstatement Declaration) form for you to complete.

Please note that the Declaration of Health along with any arrears owing only need to be returned if you intend to reinstate your policy. Outstanding arrears won't affect your credit rating.

Follow the steps below to complete the Declaration of Health form:

Before you begin, read the information on Pages 1 and 2. 

On Page 3, write your "Full Name", "Policy Number" and "Date of Birth" into the appropriate boxes. 

(Policy numbers start with 0s/00/01/02/UK________. Application Numbers starting AN0_______ won't be accepted.)

Write the "Due date of the last paid premium" into the next box. (This date will be in the letter you received with the Declaration of Health). If you have never made a payment on this policy then you will need to write your "Policy start date". (This date will be in your Policy Documents)

Put an "X" beside "Yes" or "No" in relation to Question 1.

"Since the due date of the last paid premium, or if no premiums have remained paid, the policy start date, have you had any illness, injury or medical symptoms (whether a doctor has been consulted or not), or had or been advised to have any medical consultation, hospital investigation, treatment, operation, blood test or psychiatric advice. Medical symptoms include weight loss or gain of more than 5kg (11lbs)"

If you answer "Yes" then write a "description" of the condition along with the "date" that it first occurred into the appropriate boxes.

Please read the examples on Page 4 to help you with this.

Put an "X" beside "Yes" or "No" in relation to Question 2.

"Have you used cigarettes, cigars, pipes or nicotine replacements in the last 12 months - including occasional use?"

Now read the "Customer Declaration" and sign in the "Signature" box. Enter today's date i the box marked "Date".

Put an "X" beside "Yes" or "No" in relation to authority for Legal & General to contact you by telephone. 

If you answered "Yes" the please provide the most suitable contact numbers for "Home", "Work" or "Mobile" in the appropriate boxes. Also put an "X" beside the most convenient times to be contacted.

Please return the Declaration of Health form along with your completed new Direct Debit Instruction in the pre-addressed envelope to:

(C/O) Payments Team,

Legal & General Assurance Society Limited
City Park,
The Droveway,
East Sussex,

Once processed, you will receive either, a letter from Legal & General to confirm reinstatement OR a telephone call to discuss further the information you provided.