Quick Quote Questionnaires

Improve Your Placement Ratio

With Field Underwriting

The quickest way to lose a sale is to misquote the client.  At Special Risk Services, we are experts at determining which company will offer the best rates for your clients based on each company’s underwriting guidelines.  To take full advantage of our expertise, quality field underwriting is a necessity.  Start with this Pre-Underwriting Tool/Quick Fact Finder. When a specific underwriting condition is discovered, use the below questionnaire(s) to intelligently question your client and obtain the necessary information to evaluate your case.   Email the completed questionnaire to us, and we will then provide you with an accurate quote.

For all life cases, start with our Pre-Underwriting Tool/Quick Fact Finder.

Medical Impairments

Cardiac/Heart Conditions

Cancer

Non-medical Questionnaires

Kidney Related

Other

Authorization Form

The Authorization Form or Authorization Form 15-Point Type (required in CA) needs to be completed, signed and submitted to CPS in order to informally shop an impaired risk case. We have recently added a fillable PDF of the All States version that can be completed and printed right through your browser.

  • For cases with face amounts of $1 million and/or $5,000 estimated annualized premium and up, CPS will obtain the medical records upon receipt of the Informal Inquiry Form.
  • For cases with face amounts of $250,000 and/or estimated annualized premium of $1000 and up, please submit the medical records along with the Informal Inquiry Form.

Authorization Form (All States) Necessary to shop impaired risk case.

Authorization Form 15 Point (Required in CA) Necessary to shop impaired risk case.