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We may obtain immediate death benefit coverage at favorable rates for many risks that most carriers will decline or rate-up to affordable levels.

 

 

View and complete online questionnaires for common impairments

 

 

 

Want to download and print a form to complete and fax?

👉 Simple Form

👉 Detailed Form with Medical Authorization

👉 Medical Authorization Form

  • Coronary By-Pass
  • Heart Value Replacement
  • Depression
  • Pacemaker
  • Current Social drinking
  • Recreational marijuana use
  • Bad driving record
  • Drug Rehab
  • Hepatitis A, B or C
  • Alcohol Rehab
  • Diabetes-adult onset
  • Obesity
  • Diabetes-adults with juvenile onset
  • Foreign nationals
  • Prozac
  • US citizens traveling or working overseas
  • DUI
  • Angioplasty

… and many, many more impairments favorably considered.


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