Let's get started! What are your goals for life insurance?
Select all that apply.
Who depends on you financially?
This helps us customize your plan. Select all that apply.
Great! We'll get your coverage options in as little as 5 minutes.
How it works
When would you like to be covered by life insurance?
Provide your sex at birth
How many children do you have under 18?
This helps us estimate your family coverage needs.
About how much remaining debt/mortgage do you have?
Term life insurance sounds like a good fit!
A Term Life policy helps cover your financial obligations, like debt and children's tuition, for a set period of time (term) at a fixed monthly price.
If you were to die during your policy term length, they would get a lump-sum payout that can help cover the following things:
Living expenses
Covering everyday costs like groceries and bills helps ensure your family's daily needs are met.
Children's tuition costs
The cost of higher education can range from $50k to $200k+ per child.
Mortgage coverage
Help your family keep their home and maintain stability.
Up next
What country were you born in?
What state were you born in?
Are you a citizen or permanent resident of the USA?
What's your zip code?
What's your birthdate?
Confirm your name
This helps us verify your identity so you can get your Real Rate, not just an estimate.
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Confirm your email
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By clicking "Next", I confirm that I am the applicant and that I have received, read, and agree to: HIPAA Authorization, E-Sign Consent, Phone/SMS Consent, Privacy Policy, and Terms of Use.
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Please confirm the last 4 digits of your social security number
This helps us calculate your unique Real Rate, not just an estimate.
What's your mobile phone number?
Insurance companies require this to provide coverage.
What state is your driver's license issued from?
What's your home address?
Basics
What is your height?
Basics
What is your weight?
Medical questions
Has a biological parent or sibling been diagnosed with or treated by a medical professional for any of the following?
Medical questions
Have you ever been diagnosed, treated, or given medical advice by a medical professional or tested positive for HIV (Human Immunodeficiency Virus) or AIDS (Acquired Immune Deficiency Syndrome)?
Medical questions
Have you ever been diagnosed, treated, or given medical advice by a medical professional for any of the following:
Medical questions
In the last 5 years, has a medical professional recommended any test (other than HIV), treatment, or consultation that you have not yet completed, or are awaiting results for?
Financial
What is your marital status?
Financial
What is your annual pre-tax income?
Financial
What is your current employment status:
Financial
Have you filed bankruptcy in the past 5 years?
Insurance history
Do you have, or have you applied for, any other life, health, disability insurance or annuities?
Add your beneficiaries
A beneficiary receives the policy payout in the event of your passing. These individuals can be changed at any time.
Add a beneficiary
+ Add another
📧
Add a secondary addressee
Click here if policy notices should be mailed to an additional address. (Optional)
It's in! Sit tight as we review your application...
Verifying your information
Congratulations! You are approved for SecureLife Term Life - Choice with living benefits
Review coverage amount and term length.
Policy amount (coverage)
Policy length (term)
Your Details
Address
416 E 4th St
Long Beach, MS 39560
LAST STEP!
Landon, you're a step away from protecting your loved ones.
Just add payment and get peace of mind.
By clicking "Start my coverage" I certify I am authorized to use this bank account or credit card.
Money back guarantee
No questions, no fees, just your money back.
Cancel anytime
Free cancellations.
Application Submitted Successfully!
Thank you! We've received your application.
Our team will review it and contact you within 24-48 hours.
Check your email for confirmation details.