Welcome to:
THE ABBOTT & FILLMORE AGENCY, INC.'S
LIFE QUOTE!
INSURANCE FOR ARIZONA ON THE NET!
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LOW COST, HIGH QUALITY, LIFE INSURANCE
COMPARISON QUOTE SERVICE
Get Low Cost Quotes From Several Companies With One Input!
This site is for the state of Arizona.  Click here for Michigan; Click here for Indiana
--stay tuned for more states--

After submitting the requested information, we will calculate quotes from several top competing insurance companies. Of course, no coverage is bound and any quote is subject to company approval and underwriting.  When you get the quote, if you are interested, we can make application paperwork simple. This is our "No Hassle" service.

Also, please note:!  Life insurance needs vary tremendously from person to person depending on your particular situation and wants.  Many in the industry say that, as a rule of thumb, you should have life insurance at 6X your annual income.  You could use that if you want, but frankly, I don't believe in such a simple calculation.  Give us a call to discuss your situation for us to help you understand your need. We don't give sales pitches--just honest information and advice!

The quotes available online here are for some of the most common types of insurance.  We offer several other types and can tailor it to your specific need.  Call us for details at 1-800-243-6296..

Please enter the following information (All information is strictly confidential.  We do not sell or give any informatioin to any other company or organization!)

Set your viewing font (Under Options, Gen'l Preferences) to 12 if you don't want to be confused!

SECTION A
PRIMARY INSURED INFO:

 If you are not in Indiana or Michigan, STOP HERE!  We can not service other states yet.

Full name of person for life insurance:

Birthdate       
Occupation & Employer
Height:
Weight:
Is your cholesterol less than 200?   Yes         No        Don't Know
Has this person smoked one or more cigarettes in last 12 months?     
How's your health? Have you had any history of heart disease, cancer, high blood pressure, etc?   Are you on any medications?
Please explain your health history:
.Will this be replacing any existing life insurance policy?
  Please explain:
A JOINT life policy would pay of if anything happened to the insured OR his/her spouse.  Because of this, it is more expensive than one that is not Joint Life.
Do you want a JOINT life proposal?    
   
If you answered yes to JOINT life, please complete section B with the same info on your spouse, OTHERWISE SKIP TO SECTION C

SECTION B
JOINT LIFE INFO ON SPOUSE (SKIP TO SECTION C IF YOU DON'T WANT JOINT LIFE
Full name of spouse:
Spouse Birthdate       
Spouse Occupation & Employer
Spouse Height:
Spouse Weight:
Is Spouse's  cholesterol less than 200?   Yes          No       Don't Know
Has spouse smokedone or more cigarettes in last 12 months?     
How's your spouse's health? Any history of heart disease, cancer, high blood pressure, etc?  Is he/she on any medications?
Please explain health history:

SECTION C
BASIC INFO (NEEDED ON ALL QUOTE REQUESTS)
   
Your email address:              
Your home phone number:    
Your work phone number:    
Your fax (if want quote faxed):
Your home street address:    
Your city:                              , State:
Your ZIP Code:                   
COVERAGE WANTED:
(to choose more than 1, hold down your Ctrl key
Enter type of insurance wanted:     

If you chose anything OTHER than Mortgage Life, complete the following Section D
If you chose ONLY Mortgage Life, skip to Section E

SECTION D
TERM, UNIVERSAL, OR WHOLE LIFE INFO
What amount of Life Insurance do you want?

SECTION E
MORTGAGE LIFE INFO (SKIP TO SECTION "F" IF YOU DIDN'T CHOOSE MORTGAGE LIFE

If you chose Mortgage Life, pease answer the following two questions:
1. Amount of Mortgage
2. # of Years Amortization Left on Mortgage

SECTION F
GRAND FINALE QUESTIONS-FOR ALL

 Did you fill in all the information? 

How did you find our Web Site? 

If other search engine or "other", which one or how?

Did you find our quote form easy to use?  Put any ideas for improvements here:

Thank you for completing our online quote form. Please let us know how you would like us to send you the quote: E-Mail Fax Phone Call