Application for Final Expense Whole Life



Insured: , age . Smoke?
You're applying for - BENEFIT: $, expected premium $ mo.

[click to change benefit or age/gender]

Complete the APPLICATION below

Questions? Call 877-LIFE-GUY

Coverage starts after underwriting approval of your rate based on your health history. You will receive a policy by mail. A telephone call with the Underwriter may be necessary before approval. NO MEDICAL EXAM needed for benefits up to $40,000. Over $40,000 it's possible to need physical measurements and urine sample/test, possibly a blood test needed depending on your age, benefit amount applied for and time since last Dr. visit.

Customer Satisfaction Guarantee: you have 30 days to receive full refund, if the coverage does not satisfy your needs. After the first 30 days, you may cancel at any time and coverage will stop at your request. Otherwise, your coverage will last for the life of the policy and premiums will never increase during that time.

Questions? Call 877-LIFE-GUY