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Annual Reviews Yield Results for Clients

Posted on April 15, 2016 by ecrowe
Like an annual physical, an annual review of your clients’ income protection insures they maintain good financial health and address any gaps in coverage.
read more
Posted in DI Tips, Selling DI, Uncategorized

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9535 E. 59th Street, Suite C Indianapolis, IN 46216 Toll Free: (800) 925-3898 Telephone: (317) 803-3330 FAX: (317) 803-3370

E-mail: secrowe@sourcebrok.com

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    Client’s Name:
    Client’s DOB:
    State of Residence:
    Gender:
    Tobacco Use?
    Occupation:
    Title/Duties:
    Benefit Period:
    Elimination Period (days):
    Current Year Income: $
    Income 2 years ago: $
    If business owner, how long?
    Percentage of manual duties:
    If less than one full tax year in business:
    Former Occupation/Duties:
    Former Salary: $
    Coverage In Force (fill all appropriate fields)
    Is there Group LTD?
    Replacement Percentage:
    Benefit Group LTD Cap: $
    Benefit Amount: $
    Is there Individual Disability Income coverage?

    Any health problems? Currently on any medications or counseling? Height weight ratio? Any special notes?

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      Client’s Name:
      Client’s DOB:
      State of Residence:
      Gender:
      Tobacco Use?
      Occupation:
      Title/Duties:
      Benefit Period:
      Elimination Period (days):
      Current Year Income: $
      Income 2 years ago: $
      If business owner, how long?
      Percentage of manual duties:
      If less than one full tax year in business:
      Former Occupation/Duties:
      Former Salary: $
      Coverage In Force (fill all appropriate fields)
      Is there Group LTD?
      Replacement Percentage:
      Benefit Group LTD Cap: $
      Benefit Amount: $
      Is there Individual Disability Income coverage?

      Any health problems? Currently on any medications or counseling? Height weight ratio? Any special notes?

      Producer’s Name:
      Phone:
      Email:

      Your request has been sent.

      Your request has been sent.
      Thank you!