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Disability Insurance Leads
Do you need high quality disability insurance leads directly from interested consumers? Are you looking for the highest return on investment in the industry? We are the top provider for exclusive, shared and non-exclusive insurance leads. We guarantee you'll enjoy exceptional customer service and receive a quality product each and every time!
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Life | LTC | Homeowners | Health | Disability | Auto | Annuity

SAMPLE DISABILITY INSURANCE LEAD

Name:

James XXXXXX

Address:

XXXXX X XXXXX XXXX

City:

Philadelphia

State:

Pennsylvania

Zip:

XXXXX

Work Phone:

XXX-XXX-XXXX

Home Phone:

XXX-XXX-XXXX

Email Address:

xxxxxx@yahoo.com

Best Time To Call:

12- 6 p.m.

Are you requesting this quote for yourself?

Yes

Relation to the person you are requesting for?

Me

Do you use Tobacco:

No

What type of tobacco products:

N/A

Height:

5" 7'

Weight:

178

Gender:

Male

Date of Birth:

09/14/62

Are you Self - Employed:

Yes

If ``No", who is your employer:

Scirotto Chiropractic

What type of business are you employed with:

Chiropractic Clinic

What is your position:

Doctor of Chiropractic

How many years have you been with your current employer:

3 - 6 Years

Occupation (IMPORTANT be as specific as possible):

Doctor of Chiropractic

Present Monthly Gross Income:

$10,000.00

Monthly Benefit Requested:

$7,500.00

Do you participate in any hazardous activities:

None

Waiting Period (time between injury and pay-out):

30 Days

Benefit Period:

5 Years

Health Problems:

None

Medications:

None

Names/doses:

N/A

Family member with Heart Disease/Cancer:

None

Describe:

N/A


We guarantee you'll enjoy exceptional customer service and receive a quality product each and every time!

 
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