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LIFE INSURANCE
Coverage Details
Your Coverage
Coverage Amount
$25,000
$50,000
$70,000
$100,000
$150,000
$200,000
$250,000
$300,000
$350,000
$400,000
$450,000
$500,000
$550,000
$600,000
$650,000
$700,000
$750,000
$800,000
$850,000
$900,000
$950,000
$1,000,000
$1,100,000
$1,200,000
$1,300,000
$1,400,000
$1,500,000
$1,600,000
$1,700,000
$1,800,000
$1,900,000
$2,000,000
Product
1 year term
10 year term
15 year term
20 year term
25 year term
30 year term
35 year term
40 year term
Level term to 65
Level term to 70
Level term to 75
Traditional Term 100
T100 20-pay
Whole Life / Life Pay
Whole Life / Pay to 65
Whole Life / 25 Pay
Whole Life / 20 Pay
Whole Life / 15 pay
Whole Life / Quick Pay
Unique Whole Life
Living Benefits
Single Person Funeral Plan
Province
Ontario
Payment Method
Annual
Semi Annual
Quarterly
Monthly
Underwriting Risk
Elite
Preferred
Regular
Simplified
Guaranteed
Do you Smoke
Yes
No
Your Personal Information
Name
Email
Phone
Age
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
Gender
Female
Male
When was the last time you used the following products:
Cigarette
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Pipe
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Cigarello
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Marijuana
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Cigar
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Snuff
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Chew
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago
Prescribed
Never
Within last 12 months
1-2 years ago
2-3 years ago
3-4 years ago
4-5 years ago
5-6 years ago
6-10 years ago
10-15 years ago
15-25 years ago
25+ years ago