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Cancer Insurance Quote

Cancer Insurance Quote

Unlike the many illnesses covered under a Critical Illness Insurance policy, Cancer Insurance specifically covers Cancer. This is simplified insurance coverage that allows you to get coverage based on a few questions.

For a Cancer Insurance quotation, please complete and submit the following form. You will receive an Illustration from an Advisor in Adobe Reader (PDF) format.

Cancer Insurance Quote Request

First Name*

Last Name*

Email*

Phone

Street Address

Street Address Line 2

City

Province

Country

Date of Birth

Sex Male Female

Smoking Status Non-Smoker Smoker

Coverage Required

Term Required

Coverage Amount

In your lifetime, have you ever been diagnosed with acquired immunodeficiency syndrome (AIDS) or tested positive for the human immunodeficiency virus (HIV)? Yes No

Do you have, have you ever had, have you noticed signs or symptoms for which you have not consulted a physician yet, or are you waiting for a test or test results for any form of cancer or malignant tumour? Yes No

In your lifetime, have you ever been diagnosed with cancer or a malignant tumour, had signs or symptoms of cancer, consulted a physician or undergone tests showing abnormal results for cancer; are you awaiting a test for cancer or have you had a test for cancer and awaiting the results? Yes No

In the past two years, have you had an application for critical illness or cancer insurance declined or postponed by any insurance company, including Excellence? Yes No

Have two or more members of your immediate family (father, mother, brothers and sisters) suffered from or been diagnosed with cancer before the age of 60? Yes No

Comments

Thank-You for your Submission

A group benefit specialist will be in contact with you shortly.

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All products offered soley by Neil Lecky as an agent of Alliance Financial Group unless noted otherwise.
Life Insurance and Segregated Fund products are offered through Alliance Financial Group
The information on this website is intended for use by persons resident in Canada, in the Province of Ontario only.
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