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Welcome Tobacco
 

Our online quotes will accurately put you in the “ball park” but ultimately you will choose from insurance plans that are customized to your personal lifestyle and medical history.

One of our experienced, professional, licensed agents will contact you within 24 hours to discuss your options and help you choose an affordable plan that is right for you. If you are ready now, call us toll free at 1-800-264-8114.

When purchasing insurance through Shop Term Quotes Insurance Services,
you are investing in your peace of mind.

 

  • Did you know that there is difference between Cigar smokers, Cigarette smokers and Chewers? They represent varying degrees of health risks and some term life insurance carriers will acknowledge the difference which will be reflected in the underwriting class you ultimately qualify.
  • Some tobacco users can qualify for Preferred Non – Smoker rates! This means you can save and get more coverage for your term life insurance dollar.
  • A ShopTermQuotes.Com licensed agent can guide you through the term life insurance maze. Call us at 1-800-264-8114 or email us at LicensedAgent@shoptermquotes.com
 
Underwriting Questionnaire For Tobacco

Complete our fast and easy underwriting questionnaire to receive a preliminary offer in 48-hours or less

Personal Information
Full Name: Height:
City: Weight (lb):
State:
Phone: Occasional Tobacco User: Yes No
Fax: Insurance Amount:
Email: Plan of Insurance: Term UL SUL
Date of Birth: mm dd yy Additional Insured's Name (only if applying for Survivor UL)
Sex: Male Female
Tobacco
Current use: List all forms and quantity of current nicotine use.
Past use: List all forms and quantity of past nicotine use.
If applicant was ever a cigarette user, provide as much detail regarding smoking history as possible. For example, when they started, if they have ever quit, and if there has ever been any change in the amount used.
Other information
© 2003 Form Provided by www.customquotepage.com