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9/3/2010 11:57:48 AM

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CLIENT TESTIMONIALS

I have been dealing with them for years. Besides the surety of competitive rates from top-notch insurance carriers, I always enjoy dealing with a simplifying, honest and straight-forward approach.

Erik Solorzano, Fontana, CA

Your real-time online quoting for life insurance rates is a great way to get an idea of what is out there.

Christie Gupta, Houston, TX

In less than 30 seconds, I had my life insurance quote at your website.

Kendra Mays, Bazine, KS

We received good service, great insurance company, and competitive rates, all at one place. My referrals are for you.

Thomas and April Fung Hollywood, CA

I am very impressed by your professional and friendly service for those on H1B visa.

Chandra K .Bhumireddy
Dallas, TX

I received the best rates from an A+ rated company. I would gladly refer your life insurance advisors to anyone.

Agnes Sowemimo, Norcross, GA

I thought I would never be able to get life insurance till I contacted you. Thank you.

Victoria Brown, Suffolk, VA

I didn’t think life insurance could be affordable at my age. Thank you for your help.

Eddo Bottiroli, Los Angeles, CA

With a Critical Illness policy we had through you, we sleep better at night.

Michelle Solorzano, CA

I remember when my insurance made a mistake and overcharged me. The speed at which you guys took care of it was amazing.

William Young, Chula Vista, CA


There is a number of Burial Life or Final Expense Life insurance plans available in the market. Considering the wide variety of options, it would not be fair to promote just one insurance carrier. Your answers to the questions below will help us understand your peculiar situation and serve you more appropriately. Once we know who you are and where you stand in terms of health,
needs and affordability, we can then shop through multiple insurance carriers to get you a suitable insurance plan. Please fill up the form on this page to help us serve you better.

Main Features of Burial Insurance

Burial insurance is whole life with cash value
Premiums and benefits remain level
Easy medical underwriting; no exam in most cases
Face amount between $1000 to $75,000
Simplified application
Anyone under age 85 can be insured at preferred, standard or graded risk
Benefit is paid to a beneficiary income tax free
Double indemnity option available in the event of death by an accident
Loans can be taken against the policies

Burial Insurance Quote Form.

* Required Field

Title : *

Mr. Mrs. Ms. Miss.

First Name : *

Last Name : *

Gender : *

Date of Birth : *

Tobacco use in last 3 years : *

Yes No

Height : *

feet inches

Weight : *

pounds

Has weight changed in last 12 months : *

Yes No

Amount of Coverage : *

Address : *

Apt or Unit (if any) :

City : *

State of Residence: *

Zip Code : *

Who is this insurance for: *

Telephone Day :

Telephone Evening : *

Cell Phone :

Comments/Important Information : *

PROCEED TO MEDICAL QUESTIONS TO FINISH >

Are you (the proposed insured) currently on oxygen, hospitalized or confined to a nursing home or long term care facility?
Yes No

During the past two years have you been advised to have any surgical procedure that is still pending or have you been treated or are you being treated by a medical professional for any of the following diseases or disorders:

Congestive Heart Failure

Yes No

Cirrhosis of the Liver

Yes No

Alzheimer’s/Dementia

Yes No

Heart Disease

Yes No

Drug or Alcohol Dependency

Yes No

Diabetic Coma/Insulin Shock

Yes No

Stroke

Yes No

Kidney failure (including dialysis)

Yes No

Amputation (caused by disease)

Yes No

Cancer (other than skin)

Yes No

Emphysema

Yes No

Immune System Disorder

Yes No

Chronic Obstructive Pulmonary (lung) Disease

Yes No

Have you been diagnosed for or received treatment for Acquired Immune Deficiency Syndrome (AIDS), AIDS-Related Complex (ARC), or an AIDS-related condition; or tested positive for the Human Immunodeficiency Virus (HIV)?
Yes No

In the past two years, have you been treated with medication, surgery, or therapy for, or been diagnosed for any of the following:

a. Diabetes requiring insulin, diabetic complications;
Yes No

b. Heart attack, angina, stroke, congestive heart
Yes No

c. Liver disease including cirrhosis or hepatitis; failure, irregular heart rhythm, pacemaker
Yes No

d. Alzheimer’s or Parkinson’s disease; implant, stent, or any procedure to improve
Yes No

e. Alcohol or drug abuse; circulation to the heart or brain;
Yes No

f. Cancer
Yes No

g. Kidney failure, kidney dialysis, or renal lung or respiratory disorder including emphysema, insufficiency; asthma or tuberculosis;
Yes No

h. A mental or psychiatric disorder including anxiety or depression;
Yes No

i. Had any type of amputation caused by disease; had any type of organ transplant; been diagnosed with a terminal disease?
Yes No

In the past 12 months, have you had ongoing assistance performing regular activities of daily living (ADL) such as bathing, dressing, eating, using the toilet independently, taking medications, walking independently without the use of a wheelchair or walker; used oxygen equipment; or been confined to bed?
Yes No

Please provide the list of medications you are taking at this moment:

Name of the medication	Amount and Frequency

In the past 12 months have you been declined for life or health insurance?

Yes No

Are you a US citizen or permanent resident? : *

Yes No

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FREE LIFE INSURANCE QUOTES

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For Term Life, Return of Premium Term and Universal Life Insurance plans. Compare top-rated carriers and save.

Birthdate:
Gender: Male Female
Do you smoke or use tobacco?: Tobacco Guidelines Yes No
Height: Height & Weight Guidelines feet inches
Weight: pounds
Health: Medical Guidelines Regular Regular Plus Preferred Preferred Plus
State:
Duration:
Amount of Insurance:
Premiums Paid: Annual Monthly
First Name: * (Required)
Last Name: * (Required)
Day Time Phone: * (Required) Ext.
Evening Phone:
Email: * (Required)

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