Hiscox Limited

Notice of Dividend Amount • Apr 11, 2022

2022 Hiscox Ltd Scrip Mandate Form

Section 1 YOUR DETAILS

Full name of First Named Holder	Company to which this plan applies
1.	Hiscox
Joint Holder(s) – Maximum four (4) holders	Shareholder reference (8 or 11 digits) (Note 1)
2.
3.	This application only applies to the holding above. Separate applications must be completed for additional holdings held in
4.	the above Company.
Full Address of First Named Holder	Shares to which this plan applies
	Ordinary Shares of 6.5p each
Country
Post Code

IMPORTANT

If you are in any doubt as to the action you should take, you should consult your stockbroker, solicitor, accountant or other independent financial adviser authorised under the Financial Services Markets Act 2000, if you are in the United Kingdom or, if not, from another appropriately authorised independent financial adviser. This Scrip Mandate Form is not transferable.

To be effective for a particular dividend, your Scrip Mandate Form must be received by Equiniti (Jersey) Limited, c/o Equiniti Limited by 5pm on the published final date for receipt of elections.

If you wish to continue to receive your dividends in cash or you hold a beneficial interest in shares through depositary interests issued by Equiniti Financial Services Limited, you should NOT complete or return this Scrip Mandate Form. Forms received in respect of depositary interests will not be accepted and will be rejected.

Unless revoked, this Mandate will apply to all future dividends in respect of which a scrip dividend alternative is offered by the Directors in respect of your entire shareholding. This Mandate may be revoked by you at any time by writing to Equiniti (Jersey) Limited, c/o Equiniti Limited at the address overleaf.

To the Directors of Hiscox Ltd

I/We the undersigned, being the registered holder(s) of shares in the Company, confirm that I/we have read and understood the Terms and Conditions of the Scrip Dividend Scheme as set out in the circular dated 11 April 2022. I/We hereby elect to receive an allotment of New Shares instead of cash, in respect of any future dividend for which a scrip dividend alternative is offered, for my/our maximum entitlement, subject to and in accordance with the Bye-Laws of the Company and the Terms and Conditions of the 2022 Hiscox Ltd Scrip Dividend Scheme as modified from time to time.

By signing this Mandate form, I/we confirm that I/we am/are not prohibited from receiving or electing to receive scrip dividends in accordance with the Terms and Conditions of the 2022 Hiscox Ltd Scrip Dividend Scheme and the regulatory and legal requirements of any applicable overseas jurisdiction.

I/We hereby authorise you to make payment of or to retain any cash balances to be carried forward under the 2022 Hiscox Ltd Scrip Dividend Scheme in accordance with the Terms and Conditions of the 2022 Hiscox Ltd Scrip Dividend Scheme. This Mandate will apply for all future dividends that are paid by the Company, pursuant to the 2022 Hiscox Ltd Scrip Dividend Scheme and any successor scheme(s), on all the shares registered in my/our name(s), until this mandate is revoked by me/us by notice in writing to Equiniti (Jersey) Limited, c/o Equiniti Limited.

I/We authorise you to send me/us by post, at my/our own risk, a share certificate in respect of New Shares allotted and issued to me/us under the 2022 Hiscox Ltd Scrip Dividend Scheme and any successor scheme(s).

Signature – holder 1* (Note 2)

Signature – holder 2

Signature – holder 3

Signature – holder 4

If signing as Power of Attorney or other authority please print your full name (Note 3)

Date (Note 4)

*If you hold your Hiscox Ltd shares jointly with others, you must arrange for all joint holders to sign this Scrip Mandate Form. In the case of a corporation, this form should be executed under its common seal or be signed by a duly authorised official whose capacity must be stated.

GUIDANCE NOTES

You should find the answer to any queries you have, as well as a copy of the full Terms and Conditions for the 2022 Hiscox Ltd Scrip Dividend Scheme, online at www.hiscoxgroup.com/investors.

However, if you would like to speak to someone then you can contact the Shareholder Services Helpline on: UK: 0333 207 5965

International: +44 121 415 0269

A textphone service is also available on:

UK: 0371 384 2255 International: +44 121 415 7028

Lines open 8.30am to 5.30pm (UK time), Monday to Friday (excluding public holidays in England and Wales).

Alternatively you can write to us at the address below.

Once completed please send your form to: Equiniti (Jersey) Limited C/O Equiniti Limited Aspect House Spencer Road Lancing West Sussex BN99 6DA United Kingdom

Note 1: Shareholder reference (8 or 11 digits)

This can be found on your share certificate, Nominee Statement or previous tax voucher/dividend confirmation.

Note 2: Print & Sign

All shareholders must sign the declaration and print their full name in the appropriate boxes provided.

Note 3: Power of Attorney (if applicable)

Complete your full name here if you are signing as a power of attorney.

To avoid rejection if you have not previously recorded the Power of Attorney document with us please ensure that you send us either the original document or a photocopy with this form. If you are sending a photocopy, please make sure every page is signed with an original signature, either by the person granting the Power or by a solicitor or stockbroker, to confirm that it is a true and complete copy of the original.

Note 4: Today's Date

Dividend Election deadline

To be effective for a particular dividend, your Scrip Mandate Form must be received by Equiniti (Jersey) Limited, c/o Equiniti Limited by 5pm on the published final date for receipt of elections.