Disability Request

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Steve Shorr Insurance
Established   1981

San Pedro (Los Angeles) California
(310) 519-1335  Toll Free (888) 277-8219

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We offer the lowest legal rates anywhere

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 *means it's a required field
Your occupation* 
Duties*
Age*
Sex*
Smoker last 5 years?   How much?  When did you stop?*
Annual Salary*  This year - last year
If Self - Employed - NET after Business expenses*  This year - last year
Office in home or outside?*
If you unfortunately go disabled - how long can you wait till we start paying benefits?  (The longer you can wait - the lower the premium)*
How long would you like to receive benefits for?  ie 2 years, 5 years, to age 65, lifetime
Other Disability Coverage in force - including thru your employer?*  If none, write none.
Any medical conditions we should know about?  ie - already disabled, high blood pressure, depression, back or spinal problems, etc?
How often and how much do you smoke?  If none, so state
   
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We proudly represent and are Authorized Agents for:

Health Net   - A better decision
Health Net - Group - Individual & Families

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Jackson National Life

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(310) 519-1335 

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Steve Shorr, President

Buy Now

We proudly represent and offer the lowest legal premiums as we are Authorized Agents for:

Health Net   - A better decision
Health Net - Group - Individual & Families

Jackson National Logo
Jackson National Life

Pacificare Logo & Hyperlink
Individual Plans
Group Plans

Anthem Blue Cross Logo
Blue Cross of California

The Standard Insurance Company Logo & Hyperlink
Standard Insurance


Aetna

Blue Shield

Kaiser

California Choice

Better Health
View this website on Better Health Tips

Public Transportation

Privacy

Get Instant Medical & Life Quotes
INSTANT Health & Life Quotes & Proposals 

(310) 519-1335 

(888) 277-8219

Email

Get on our newsletter list

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1027 W. 11th # 3 San Pedro, CA 90731-3558

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