Impaired Risk - Quick Quotes

Below you will find a listing of QUICK QUOTE FORMS for your use. QUICK QUOTE FORMS are used to secure "firm" tentative offers from one or more of the leading imparied risk carriers on declined or special risk cases.

Select the correct QUICK QUOTE FORMS, secure as much detail as possible and fax the form to us at 602-494-0500. The data will be discussed with several carriers and illustration will be prepared for you. If there are no "surprises" in the underwriting papers, then the carrier will stay with its "firm" tentative offer.

Quick Quote Questionaires

  • Alcohol & Drug Usage
  • Build
  • Cancer
  • Cerebrovascular Accident (Stroke)
  • Chronic Lymphocytic Leukemia
  • Coronary Angioplasty & Bypass
  • Depresion
  • Diabetes
  • Driving Violations
  • Heart Attack
  • Hepatitis & Elevated Liver Functions
  • Heart Conditions
  • Hypertension
  • Kidney Transplants
  • Multiple Sclerosis
  • Other Illness
  • Paralysis & Spinal Cord Injury
  • Parkinson's Disease
  • Preferred Risk
  • Rheumatoid Arthritis
  • Sarcoidosis
  • Sleep Apnea
  • Systemic Lupus Erthematosus
  • Ulcerative Colitis/Crohn's Disease

On occassion, the carrier will require that a QUESTIONNAIRE be completed during the underwriting of a case.

THESE ARE NOT THE SAME AS QUICK QUOTE FORMS. It may be necessary to complete one of the standard forms for submission with an application. Click on the questionnaire you would like to view or print out.

  • Alcohol Usage
  • Aviation
  • Business Insurance
  • Chest Pain
  • Climbing
  • Confidential Financials
  • Coronary
  • Diabetes
  • Foreign Residence
  • Racing
  • Resident Alien
  • Seizures
  • Substance Usage
  • Tobacco Usage
  • Travel
  • Underwater and Sky Sports