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The Life Insurance Application

When you have submitted your Application Request, you will be given the opportunity to schedule your free medical exam online, which is required for most life insurance policies.  Once you have scheduled your exam, we will send your life insurance application to you via email and mail you a hard copy via Priority Mail.  We will highlight all the fields you need to complete, as there are many sections on the application that don’t need to be completed.  Alternatively, with a quick phone call, we can walk you through the application and answer any questions you may have.

Life insurance application processIf you do complete your application without our assistance, please complete all highlight areas and sign and date it.  If you make any errors while filling it out, cross through the error(s), initial it and write your correction next to it.  Do not use white-out, as the insurance company will not accept an application that has been corrected with white-out.

You can either email  us your completed application, mail the application and premium payment (optional) back to us in the postage-paid envelope or give it to the medical examiner when you have your exam.

Premium Payment

Premium payment is not required with your application.  However, you may be given the option of submitting payment with your application in order to get temporary coverage during the underwriting period.  Each insurance company has their own guidelines concerning temporary coverage, so please read the instructions carefully in your application packet.  If you do choose to submit premium with your application, please follow these guidelines:

  • Your payment should be for the modal premium quoted (annually, quarterly or semi-annually).  If you will be paying monthly, you should submit two months’ premium.
  • Make your check out to the insurance company – not to LifeInsure.com.
  • Be sure to put the same date on the check that’s on your application.

Upon receipt of your application, we will review it to make sure all required fields have been completed.  If additional information is needed, your assigned case manager will contact you to complete the application with you.  Once completed, we will forward your application and medical exam report to the insurance company for underwriting,

Next:  The Medical Exam

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Intramark Insurance Services


  • Intramark Insurance Services, Inc., Insurance Services, Glendale, CA

  • Intramark Insurance Services, Inc.
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