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Coverage Amount
How much coverage do I need?
If you are a family breadwinner with dependents, financial planners suggest carrying ten times your annual income. If you are a non-working caregiver at home, we suggest your choice of $150,000 to $500,000. If you are looking for burial coverage only, we suggest $5,000 to $25,000. Click here to access the Life Happens life insurance needs calculator.
   Needs Calculator
State of Residence
Birth Date
(Ages 14 Days - 85 Years)
Sex  Male    Female
Any tobacco, nicotine
or marijuana use?
Why do life insurers ask about this?
Nicotine use of any kind, including marijuana use, is looked at very closely by all life insurers. Smoking, chewing, inhaling in a vaporized form, consuming in edible products, and wearing a patch on the skin, all constitute use of these products. Non-admittance of marijuana use can result in a decline. Sources of information the insurer may use include: statements made on your application, telephone interviews, your paramed exam results (if one is required), your outside medical records and your Medical Information Bureau (MIB) profile. If you currently use marijuana AND any product containing tobacco or nicotine, please select the response that most closely describes your tobacco or nicotine use. Always be 100% honest when you answer tobacco use questions to ensure accurate quotes. Remember, a false statement on an application for insurance could void your coverage.
Height & Weight
 Height
 Weight (with clothes on)
Why does the life insurance company need to know your actual weight?
Weight (with clothes on) is a key rating factor with all life insurance companies. Please give an honest answer here so that you can receive accurate rate quotes. And keep in mind that the paramed examiner who visits you will be carrying a portable scale, so be honest here.
  
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Non-medical questions that can affect your premium
Did you think that life insurance companies look only at your health history? Not true. Today, life insurance companies look just as closely at many non-medical aspects as they do at your health. Items looked at very closely include disability, receiving government benefits, open bankruptcy, U.S. citizen status, hazardous activities such as mountain climbing or racing, intended foreign travel to dangerous countries, private pilot intentions, scuba diving habits, driving and criminal record status. In order to receive an accurate rate quote, always be honest in your answers to these questions.
Are you now receiving disability payments from any source? No   Yes
Are you now receiving any form of government assistance
such as Food Stamps, WIC or Medicaid?
No   Yes
Have you ever filed for bankruptcy? No   Yes
Are you a U.S. Citizen? No   Yes
Do you intend to participate in commercial aviation, private aviation, scuba diving, motorized racing, mountaineering or rock climbing, travel to any country on the U.S. State Department's Travel Warnings list, or any other potentially hazardous activities? No   Yes
Within the last 5 years, have you been convicted of either reckless
driving or driving while under the influence, received 3 or more
moving violations or had your license suspended or revoked?
No   Yes
Have you ever had any other criminal convictions, law enforcement
infractions of any kind or been on parole or probation?
No   Yes
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Family & Health questions that can affect your premium
Have you ever been rated up or declined by any life insurance
company?
No   Yes
Have any of your parents or siblings (biological only), prior to
age 60, been diagnosed with or died from:
• Cardiovascular, heart or coronary artery disease, or stroke? No   Yes
• Cancer, other than basal or squamous cell skin cancer? No   Yes
Excluding cosmetic surgery, has any doctor recommended
any medical test or procedure that you have not yet completed?
No   Yes
Do you have any pre-existing medical conditions or
currently take prescription drugs for any medical condition?
No   Yes
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