Health Class Estimator

Based on your answers to these questions, we will determine the proper underwriting class. Your final rates may vary based on additional information gathered during the underwriting process.

 

Are you presently taking medication for blood pressure, or does your blood pressure exceed 135/80?   --Select-- Yes No Don't know   Are you presently taking medication for cholesterol, or does your cholesterol exceed 210?   --Select-- Yes No Don't know   Have any of your parents or siblings been diagnosed with or died from cancer or heart disease before age 61?   --Select-- Yes No Don't know   Have you ever received medical advice or treatment for any of the following conditions: Alcoholism Anxiety Asthma Cancer (not basal cell) Depression Diabetes Drug Abuse Epilepsy Heart disease Hepatitis Kidney/Liver disorder Multiple Sclerosis Respiratory disorder Sleep Apnea Stroke Ulcerative Colitis or Ileitis Vascular Disease Other serious medical condition   --Select-- Yes No