Quick Quote Questionnaires

An evaluation for life insurance in 48 hours or less!

The Quick Quote Questionnaire asks all the relevant questions regarding your client's condition, enabling us to present you with a tentative offer!

No signatures, no application, no time consuming investigations or expensive Attending Physicians' Statements!

Use the Quick Quote System:
  • When a case has been rated / declined.
  • When you suspect that a condition will cause a rating.
  • When you need a quote in 48 hours or less.

Complete the appropriate Quick Quote Questionnaire in full and fax or email the form to your case manager.

If you don't find your client's condition in the Quick Quotes below or would like a complete underwriting analysis for any impairment, please see our underwriting page.


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Quick Quote Questionnaires
Available For The Following Impairments
Alcohol and Drug Usage
65 K
Hypertension
65 K
Build
65 K
Kidney Transplant
65 K
Cancer, all types
65 K
Multiple Sclerosis
65 K
Cerebrovascular Accident / Stroke
65 K
Other Illness
64 K
Chronic Lymphocytic Leukemia
65 K
Paralysis / Spinal Cord Injury
65 K
Coronary Angioplasty
64 K
Parkinson’s Disease
64 K
Coronary Bypass
65 K
Preferred Risk Factors
65 K
Depression
65 K
Pulmonary Disease
65 K
Diabetes
65 K
Rheumatoid Arthritis
68 K
Driving Violations
65 K
Sarcoidosis
65 K
Heart Attack / Myocardial Infarction
65 K
Sleep Apnea
65 K
Heart Conditions
65 K
Systemic Lupus Erythematosus
64 K
Hepatitis and Elevated Liver Functions
65 K
Ulcerative Colitis / Crohn’s Disease
65 K

Additional Questionnaires
Aviation
64 K
Business
85 K
Climbing
35 K
Financial
71 K
Foreign Resident/Travel
35 K
Racing
67 K
Resident Alien
42 K
Scuba/Sky Sports
84 K