Attention Agents & Brokers:
Our leads are complete and transmitted to you
within 60 seconds of submission by the consumer! You can
write an app directly from most of our forms. All of our
forms are fully validated - which means the consumer
cannot submit the form until all of the required fields
are completed.
Try
it yourself
Here is an example LTC Lead.
The personal information
has been altered, but this is an actual lead!
Interested in other
types? Click the type: |
auto |
health |
home |
ltc |
life |
Below is personal information submitted for a quote. It
was submitted by
William Prospect w.prospect@somewhere.com on Friday,
January 14, 2005 at 18:37:02
and has been assigned tracking number "CA110570".
LTC Insurance Lead via 4freequotes.com's National
Insurance Directory!
|
===============Contact
Information================ |
| Name: |
William Prospect |
| Home Address: |
1 Sycamore Street |
| City, State, Zip: |
Hayward, CA, 94541 |
| County: |
ALAMEDA |
| Daytime: |
(510) 030-8885 |
| Email Address: |
w.prospect@somewhere.com |
|
================================================= |
|
=============Applicant Info=============== |
| Primary Insured: |
William |
| Gender: |
Male |
| Date of Birth: |
04/09/1951 |
| Marital Status: |
Married |
| Tobacco Use |
I Quit over 1 Yr. Ago |
|
============== Coverage Requirements
================ |
| Benefit Period: |
Lifetime |
| Daily Benefit: |
$200 |
| Home Care Desired: |
Yes |
| Home Care Daily Benefit: |
$150 |
| Elimination Period: |
60 Days |
| Inflation Guard: |
Yes |
|
========================================= |
| Any Health Problems: |
No |
| Quote for Spouse: |
No |
| Other Insurance Carried: |
Health, Home, Automobile |
|
====================================== |
|
|
