| $250,000 | $500,000 | $1,000,000 | ||||
| Age | Male | Female | Male | Female | Male | Female |
| 30 | $12 | $11 | $19 | $15 | $31 | $27 |
| 40 | $15 | $13 | $26 | $21 | $38 | $37 |
| 50 | $32 | $24 | $59 | $43 | $107 | $7 8 |
| 60 | $75 | $46 | $134 | $87 | $259 | $ 161 |
Take a minute
to fill out the simple form below and receive a FREE quote
comparing the
best values from among hundreds of the nation's top insurance companies!
| First Name: | |
| Last Name: | |
| Address: | |
| City: | |
| State: | |
| Zip: | |
| Day Phone: | (xxx-xxx-xxxx) |
| Evening Phone: | |
| Fax: | (xxx-xxx-xxxx) |
| Email: | |
| Male or Female: | |
| Date of Birth: | (mm/dd/yy) |
| Type of Insurance: | |
| Insurance Amount: | |
| Height: | |
| Weight: | lbs |
| Tobacco Use: | |
| Health Status: | |
| Health conditions? YesNo | Explain: |
| Prescription medications?
YesNo | Explain: |
| Do you engage in any hazardous
activities? (i.e. scuba,skydiving,private pilot,etc.) YesNo | Explain: |
| Did your parents or siblings
have heart disease or cancer prior to age 60? YesNo | Explain: |
| We will open your email application to submit your inquiry. All quotes will be from insurance companies rated A-, A, A+ or A++ by A.M. Best. Actual premiums and coverage availability will vary depending upon age, sex, state, health history and tobacco use. THIS IS NOT AN OFFER OR CONTRACT TO BUY INSURANCE PRODUCTS, but rather a confidential informational inquiry. All information submitted is strictly confidential, and will be given to an insurance professional licensed in your state of residence, who will contact you and provide your quote directly. Further transmissions of this email may be stopped at no cost to you. PLEASE CLICK HERE AND TYPE REMOVE. 4:24:59 PM |
This archive was generated by hypermail 2b29 : Sun Apr 29 2001 - 20:25:33 PDT