About Life Insurance - Life Insurance Profile

The Basics
Common Questions
Key terms
How to get life insurance

Why does an insurance company want to know all this information about my health, my family's health, and what I like to do in my spare time?

My insurance agent wants to have the insurance company's doctor examine me. Is that normal?

If I say that I don't smoke or I don't mountain climb, does that mean I can never do those things or I will lose my insurance?

This is the information you will need when you fill out an online insurance form to get quotes (estimates for how much an insurance company will charge you for a life insurance policy) or when you meet with an agent.

The easiest way to use this form is to fill out the information and refer to it when you meet with an agent or fill out information online.

Basic Information

Date of Birth
Height
Weight
Job

Is your job risky?
Could you be hurt or killed (examples of risky jobs include high-rise construction, mining and being a firefighter)?
Yes No

Have you been involved in risky activities over the last three years (such as scuba diving, mountain climbing, parasailing, sky diving, or drag racing)?
Yes No

Have you ever flown an aircraft as the pilot, co-pilot or member of the crew?
Yes No

Are you a member of the military or military reserve?
Yes No

How many moving violations (speeding tickets, etc.) have you had in the last three years?

Have you ever been convicted of drunk driving or reckless driving?
Yes No

Have you lived outside of the U.S. and Canada in the last three years?
Yes No

Do you have plans to live or travel a lot (more than a month) in developing countries (for example, countries in Latin America, South America, Africa, or Asia)?
Yes No