Find AND Enroll in the Right Health Insurance Option
Brought to you by Chris Goodbaudy,
Licensed Insurance Broker
Individual & Family Plans
Individual Dental Insurance
Penalties for Businesses
Penalties for Individuals and Families
Individual Disability Quote Request
Use the form below to request a quote for individual disability insurance:
Fill in the information below to request a quote now
Indicates required field
Date of Birth
Current State of Residence
Own your own business
Do you currently have disability insurance?
Tobacco Use in last 12 months
If Quit, Date tobacco last used
Income per year
Any Bonuses? (Enter estimated amount)
Any other considerations? (e.g. Existing work limitations, travel, special circumstances, etc.)
Who will be paying the premium?
Desired Benefit Amount?
The maximum benefit amount is typically about 60% of your current income or it can be up to a maximum amount over the lifetime of the benefit period.
Purpose of Insurance:
Replace lost personal income in the event of a disability
Reimburse lost business expenses when an employee becomes disabled
Fund a company buy/sell agreement should a partner become disabled
Replace lost retirement income due to a disability
Protect a company when a key employee becomes disabled
Disability insurance that is being required to satisfy a bank loan requirement
Current medications taken and/or medical issues
How long do you want to have to wait until benefits start?
How long do you want the benefits to be paid?
Until age 65/67
Until age 70
What policy riders would you be interested in adding?
Option to receive benefits even if disability is only partial
Regular increases in benefits to keep up with inflation
Option for premiums to not go up over time
Option to get most or all of my premiums paid back to me
Option to purchase more coverage over time
Option to have my benefits decreased by any other insurance pmts (such as Social Security)
Option to be paid benefits if the only loss in ability is to perform the same duties as my current job
Option to be paid more if I lose the ability to perform activities of daily living (in addition to not being able to work)
I agree to receiving marketing and promotional materials
Submit Request Now
Create your own unique website with customizable templates.