Section I - Express Issue Whole Life:
If you can answer no to these questions you will be approved
for up to $25,000 Graded Benefit Whole Life Insurance.

A.   Do you currently receive kidney dialysis or require oxygen use or have you received or been told that you need an organ transplant or have you been diagnosed as having a terminal illness? (Terminal illness is defined as any illness diagnosed that would reasonably be expected to cause death within twenty-four months).

B.   Do you require assistance to feed, bathe, dress or take your own medication or are you currently confined to a hospital, nursing home, mental facility, hospice, or require home health care?

C.   Have you ever tested positive for the AIDS virus or been diagnosed or treated, or recommended for treatment for AIDS (Acquired Immune Deficiency Syndrome), ARC (AIDS Related Complex) or any other immune disorder?

D.   In the past twelve (12) months:

Section II - Express Issue Deluxe:
If you can answer no to these questions you will be approved
for up to $50,000 Immediate Benefit Whole Life Insurance.

A.   In the past 2 years have you been declined or postponed for Life or Health Insurance?


B.   In the past 10 years have you been convicted of a felony or currently have pending charges for a felony; or currently on parole from a felony conviction?

C.   If under age 65, are you currently disabled, or been disabled in the last six months or at any time during the last six months received any disability compensation or been mentally or physically unable to complete 30 hours per week of active employment?

D.   In the past 5 years:

1. Have you been advised by a medical professional to have any tests, surgery, treatment, or further medical evaluation that have not been performed or do you have any medical test results pending?

2. Have you excessively used, been treated for or been advised to have treatment for alcohol or drug abuse?

3.   Have you been diagnosed or treated for, or are you currently under treatment for:

a.  Alzheimer’s Disease or Dementia?
b.  Any form of Cancer (other than Basal Cell skin cancer) or Brain Tumor?
c.  Other than preventive, maintenance or risk lowering medications prescribed, have you been diagnosed or treated for Heart or Circulatory Disorder (except controlled hypertension) or Stroke?
d.  Had surgery for any Heart Disorder (including angioplasty) or Circulatory Disorder (except varicose veins)?
e. Sickle Cell Anemia or Kidney Disease (including dialysis) or Liver Disease (including hepatitis B & C)?
f. Lung Disease (except controlled, mild asthma not requiring any hospitalization in the past 2 years)?
g. ALS (Lou Gehrig’s Disease) or Neurological disorders (except for controlled seizure disorder with no seizures in the past 2 years)?

Section III - Express Issue Premier:
If you can answer no to these questions you will be approved
for up to $100,000 Immediate Benefit Whole Life Insurance.

A.     Do you participate in, or do you have plans to participate in any hazardous sport or aviation?

B.     In the past 5 years:

1.     Have you been diagnosed or treated for, or are you currently under treatment for:

a.  Alzheimer’s Disease or Dementia?
b.  Diabetes requiring insulin treatment?
c.  SLE (Systemic Lupus Erythematosus)?