Advantis Insurance Services

 If you could choose from over 500 insurance companies - Why wouldn’t you?

Licensed in California only

Click here for a fax version.

  Life/Health Insurance Quote Request

We have tried to keep the following form as brief as possible, but please provide as much information as possible in the additional information field at the bottom for the most accurate quote. This information will be kept confidential and will be used for quote purposes only.

 Personal Information

Name

 

Street Address

 

City/State/Zip

  City State  Zip 

Contact Info

  Phone  E-mail required)

Contact  Preference

  How would you like for us to contact you? 
  If by phone, what would be the best time for us to call?

 Life Policy Information - Insured

  Name (if different from above)

  Have you used any tobacco products
  in the last year?  Yes     No

  Date of Birth  (e.g. 01/01/71)

 

  Coverage desired

 Type of Policy
  
 If term, what time period do you desire?   

  Riders available: Child    Spouse   Accidental death   Disability

 Additional Information or Comments

[Home] [About] [Contact] [FAQ]

All elements of this site, including but not limited to design and forms, copyright 2004 by Advantis Insurance Svcs

Here’s just a partial list of the hundreds of insurers we can quote for you!

American Bankers Ins. Co.
American Modern Home
American Rebiable Ins. Co.
Axa Art Insurance Company
CNA Insurance Company
Fireman’s Fund Insurance Co.
First Financial Ins. Co.
Everest National Ins. Co.
Golden Bear Insurance Co.
Safeco
Great American Insurance Co.
Gulf Insurance Company
Interstate Insurance Company
Markel American Ins. Co.
Met Life
National Casualty Insurance Co.
RLI Group Insurance Company
Scottsdale Indemnity Ins. Co.
Seneca Insurance Company
Topa Insurance Company
USLI Insurance Company
Guardian
American Empire Ins. Co.
Burlington Insurance Company
Evanston Insurance Co.
General Star Indemnity Ins. Co.
Gulf Underwriters Ins. Co.
Houston Casualty Ins. Co.
Nautilus Insurance Company
Indian Harbor Ins. Co.
Lloyd’s Insurance Company
Pacific Insurance Company
Scottsdale Insurance Co.
Tudor Insurance Company
Mount Vernon Ins. Co.
Voyager Indemnity Ins. Co.
Western World Insurance Co.
Acceptance Ins. Co.
AIG
American Equity Ins. Co.
Blue Cross/Blue Shield