Applicants

As part of your application for life insurance, you may be required to complete a phone interview. Below is a sample list of questions:

Personal physician information

  • Physician’s name
  • Clinic name
  • Address
  • Phone number
  • Date last seen
  • Reason last seen

Medications
List of prescriptions and over-the-counter medications (including vitamins):

  • Dosage
  • Reason
  • Frequency
  • Prescribing physician
  • Medical

 Have you been diagnosed with or treated for:

  • Chest pain or any disorder of the heart of blood vessels
  • High blood pressure
  • Diabetes or high blood sugar
  • Cancer
  • Acquired Immune Deficiency Syndrome (AIDS) or AIDS-Related Complex (ARC)
  • Infections caused by Human Immunodeficiency Virus (HIV)
  • Any disorder of the brain or nervous system
  • Any sexually transmitted diseases
  • Asthma or any disorder of the lungs
  • Mental or psychiatric illness
  • Other surgeries or diagnosis not mentioned above

If your response is “yes” to any of the questions above, you will be asked to provide additional information, including complete physician information, medications and dosages.

Have you:

  • Used or are you now using cocaine, amphetamines, marijuana, heroin or other drugs, except as prescribed by a member of the medical profession?
  • Had or been advised to have treatment or counseling for alcohol or drug abuse?

Family History

  • What is your mother's age, if living, or date of death?
    • Cause of death?
  • What is your father's age, if living, or date of death?
    • Cause of death?
  • Do you have any brothers or sisters living or deceased?
    • Cause of death?