Use this page to submit a life quote by answering the field underwriting questions and hitting the submit button.

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    Life Insurance Quote Requests
    Please ask and provide details in the comment box below.  Please number your responses to make it easier to provide your quotes.

    Optional: potential applicant's name or initials
    Please be sure to provide state of residency, if not in Texas.
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    1. Face amount (s) to quote: 

    2. Level premium duration (s):
    (Based on age, we can quote guaranteed level premiums for as short as 10-years, 15, 20 or even 30, 35 or 40-years or out to specific ages such as age 65, 85, 90, 95, 100 or even to age 121!  Which would you like to see?   Most term plans are only convertible to age 65, or with some to age 70 so please quote smart to avoid an E&O claim. 

    Now let's narrow down the risk classification so that you can present the most accurate quotes. 

    When quoting Nicotine &/or THC users, there are vastly different u/w guidelines. If yes, be sure to include date of last use and specific type (s) used.

    3. Any nicotine use of any kind, now or in the past 5 years?  Yes Or No.   Examples include: Cigarettes, e-cigs, vaping, ZYN, VELO, cigars, gum, patch, pill, toothpaste, Betel nut chewing or beverages containing nicotine? (Please be sure to ask "ANY type of nicotine use in the past 5 years?")  If yes, please provide specific type (s) and date of last use.

    4. Any THC based product use of any kind in the past 5 years? Y/N and if yes, type, how often used and date of last use.

    5. Best estimate of current Height:        Weight:            AND any weight loss or gain of 10 pounds or more the 12 months?   Y/N         If Yes, why/how and how much weight? Diet and exercise? Surgical procedure?  Medication?  Details matter.

    6. Currently taking any prescription medications or been prescribed any medications for chol/bp/pain/anxiety or other causes?  If yes, please provide details including name of medication, reason and when prescribed: 

    7. Any history of sleep apnea?  Y/N  If yes, C-Pap use Or other sleep apnea device used?  Or has your Dr. ever suggested a sleep study that has not been completed?  If yes, are you compliant with any prescribed sleep apnea treatment and if so, since what date?

    8. Family History- Immediate family (mom, dad, bros &/or sisters) any diagnosis or death of/from heart disease, cancer, stroke or diabetes before age 65?  If yes: Include which family member, age of diagnosis and or death, type of diagnosis or cause of death?
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    9. Any history of bankruptcy or tax liens in the past 10 years? Motor vehicle violations or DUI/DWI’s?  If yes, what and when?

    10. Has an application been made to any insurance company in the past 6 months and if yes, results of the application?

    11. Please ask the potential applicant, "Think about your medical &/or personal history?  Does anything come to mind that should be considered before providing quotes?"  Some Examples: Recommended surgery or treatments that have not been done?  Any diagnosis or treatments for Cancer, Heart issues such as chest pain, heart attack, murmurs, arrythmia, pacemaker, blockages?  Circulatory issues such as stroke, TIA or vein issues?  Diabetes, Pre-diabetes, any type tumors, anxiety, depression, arthritis, lupus, MS? If yes, need date (s) of diagnosis, type of treatment and any other details you can provide. Click here for our impairment forms

    12. Lastly, as the agent or you can ask the potential applicant: "Is there anything else you can think of, not discussed, that we should check on before quoting?"

    Please use the comment box below and be sure to number your answers.  Estimated turn around time for your quotes in 1 business day.  Contact Bill with any questions or call him to discuss your case details @ 713-771-7226.  End result of this process will be providing the most accurate quotes possible!
The Three Most Common Issues Keeping Applicants From Getting The Rate You Quoted Are:

#1 Non disclosure.  As carriers aggressively utilize electronic data searches, "forgetting" medical and/or prescription history becomes a big time killer and often a rate class killer too!  When an applicant "forgets" to mention medical history or prescribed medications to you, during phone interviews or exams, underwriting has to investigate which often includes ordering medical records they may not have otherwise needed. With the e-data available to underwriters there really is no "hiding" a person's history. It used to just be MIB but now info goes more in depth and and further back than many would imagine.
  
#2 Admitted verses Actual height and weight.  The more accurate your client is with you, the more accurate your quotes will be. "Shrinking" a couple of inches or gaining 10 lbs from when they talk to you to underwriting day really can change the outcome of u/w.

#3 Nicotine or Nicotine substitute or THC usage of ANY kind in the last 5 years.  It is no longer a "do you smoke" question.  Many carriers now go back 5 years for any type of nicotine, tobacco substitute or THC use at all. If the answer is "yes" then we need details, as shown in the above quote form, to provide you with the right carrier and rate class. Some carriers may offer non smoker rates for cigar, pipes, chew, gum etc., and same for THC use, but you need to know what they use and how often, for us to quote them right for you.