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Underwriting help...
... is available by completing the form at the right. We will assign your request to a licensed agent, who will help you determine your underwriting category and premium, and the best company with which to apply.

If you would like to estimate your own underwriting category and obtain a survey of premiums, click here, and then come back to apply for insurance.

Your underwriting category depends on many variables. Our study shows the cost of poor underwriting factors, and the cost of choosing the wrong company.

Use this form for help evaluating your underwriting factors and choosing the best company.

Coverage: Term:
Birth Date: Sex:
Tobacco: Health:
Height: Weight:
Current medications, dosage, reasons:
Has a parent died before age 60? Yes No
At what age? Cause?
First Name: Last Name:
Address: City:
State: Zip: Email:
- Work
Best time to call:
Occupation: Comments:
If you have additional questions, please include them in the Comments section.

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