Important! If you are unsure what type of insurance you need or what is best for your client, contact The Ark Group at 866.725.0777 or email to hello@arkgroup.com to discuss options.
Agent Information:
Agent name:
Phone number:
E-mail:
Client Information (basic):
Client name (important):
Client date of birth or age:
Client gender:
Client resident state:
Client Information (health history):
Client's build?
Has your client used tobacco products in the last 12 months?
- If yes, how often has your client used the tobacco product?
- If yes, date last used?
What underwriting class do you want quoted?
List any health conditions, medications, dosages, and/or hospitalizations during the past 10 years:
Client Information: (current coverage)
Does your client currently have Life Insurance?
If yes, do they own Term or Permanent?
If Term, what are the coverage details?
- Carrier name?
- Original Term length?
- How many years left?
- Any riders?
- Premium?
If Permanent, what are the coverage details?
- Carrier name?
- Type of Insurance?
- Any riders?
- Premium?
- Cash surrender value?
- Trust owned?
- Years owned policy?
Illustration Design:
Client's objective/intention for this policy?
What product do you need a quote for?
What do you want us to solve for?
- If premium solve, desired face amount?
- If face amount solve, desired premium budgeted?
Do you want this policy to be paid up at a certain age?
- If so, what age?
If an Index UL is being requested: (With these quotes we generally solve for a lower face amount to maximize cash value)
- What interest rate do you want quoted? (pick one)
NOTE: If you are new to cash value Life Insurance & unsure of how to help your client determine what is best for their situation, here are a few questions to get you started:
What is your client's annual salary?
What basic premium funding option would you like us to use?
Would you like a Term, Disability Income or Critical Insurance quote as well for your client?
- If so, what would you like to see quoted:
You're almost done! Once you have answered the required questions above, click the "Submit Form" button to send us your request. We will email your quote shortly!