Online Expression of Wish

We work closely with your Employer to deliver a unique, high quality, tailored experience aimed at all your health-related needs.

As a member of your employer’s Group Life Insurance scheme, a lump sum benefit is paid if you were to die while being a member of the scheme.

The trustees of your scheme decide who to pay your benefit to. When they decide they’ll consider your circumstances at the time of your death, and your wishes as recorded by MEC. By completing your ‘Expression of Wish’ details below, you can guide the Trustees of your scheme to allocate any benefit as you would like.

My Information

First Name *

Last Name *

Date Of Birth *

National Insurance Number *

Your Employer *

Email *

Address

Beneficiary or Beneficiaries

I wish the Trustees to consider paying any lump sum death benefits to the following person(s).

If you wish to name more than one person, please state the percentage for each person. If you wish to nominate more than four persons, please enclose a separate letter with this form.

Number of Beneficiaries

1234

Beneficiary 1

Name of Beneficiary *

Relationship to me *

Percentage of Benefit *

Beneficiary 2

Name of Beneficiary *

Relationship to me *

Percentage of Benefit *

Beneficiary 3

Name of Beneficiary *

Relationship to me *

Percentage of Benefit *

Beneficiary 4

Name of Beneficiary *

Relationship to me *

Percentage of Benefit *

Declaration

I wish the above to be considered as possible recipients of any lump sum payable on my death at the discretion of the Trustees and where more than one person is named by me above in the proportions indicated. In confirm that I understand that the Trustees can take this expression of wish form into account when deciding how to exercise its discretionary powers, but is not legally bound to do so. This supercedes an previous expression of wish signed by me.

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My Information

Beneficiary or Beneficiaries

Declaration

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