Life Insurance Policy Calculator:
Answer these questions and get a rough estimate of what your policy may be worth...
Full Name
*
First Name
Last Name
Zip Code
The zip code of your current residence
Phone Number
Date of Birth
*
-
Month
-
Day
Year
The Date of Birth of the insured
E-mail
*
example@example.com
Life Insurance Policy Information
Death Benefit
*
List the amount of the death benefit payable on this Life Insurance policy
Insurance Company
This is the name Insurance Company that issued the policy
Age of Policy - How long ago was policy purchased/issued?
Less than 2 years ago
2-5 years ago
6-10 years ago
over 10 years ago
Annual Premium
The total annual premium for this policy
Cash Value
Approximate cash value currently in the policy (put 'unknown' if you are unsure)
Medical History
Please check any health conditions that apply:
Cancer
Heart Issues
Diabetes
Hospitalized in the past 5 years
Please provide details for any conditions noted above (or any other relevant health information)
The more information we have on the insured's health increases both the value of the policy and the accuracy of the quote
Medications
Please list any medications taken by the insured
Submit
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