We're happy to prepare any disability insurance illustrations you need. To get started, we'll need some basic data about your client. In addition to the regular personal information about your prospect, there are a few extra considerations for disability income. The more of this info we have, the more confident you can be in the illustration.


  • Is this an income replacement policy? If so, you'll need good estimates for all your client's forms of income, including salary, overtime, and bonuses. You should also gather information about any existing LTD or retirement plan disability provisions.
  • What is your client's job? We'll need to know their exact job title and duties.
  • Does your client participate in any dangerous or hazardous activities? These include hobbies and sports, in addition to what he or she might have to do for work.
  • Does your client have any conditions that affect his or her ability to work? This includes mental and nervous conditions as well as physical ones.
  • Is this for key employee coverage? If so, you'll need to know who will be paying for what part of the premium (employer/employee/both) and who will get the benefit payments if disabled.
  • Is this for buy-sell disability? If so, we'll need accurate data on all owners and a current business valuation.

Agent Information

Client Information

Coverage Information

If "Yes", existing coverage amount(s) and replacement information:

Benefits to Quote?

Submit Your Request

Agent Information

Client Information

Coverage Information

If "Yes", existing coverage amount(s) and replacement information:

Benefits to Quote?

Submit Your Request

Agent Information


Client Information

Gender:
Who is paying the premium?
Is there other coverage in force?
Medical Conditions:

Benefits to Quote

Disability Insurance

Elimination Period:
Benefit Period:
Optional Benefits:

Disability Buyout

or
Elimination Period:

Still have questions? Call us at 1-800-823-4852.