Universal Life Insurance Wisconsin

Universal Life policy is designed to allow the policy owner the flexibility to determine the amount and frequency of premium payments and to adjust to policy face amount up or down to reflect changes in needs without issuing a new policy. Some policies include optional riders to purchase additional protection for Long Term Care and Accelerated Benefit for Terminal Illness. This policy can offer you competitive current interest rates and cash value accumulation.

Get Peace of Mind!

Let us help you navigate your life insurance options!

Consult with a professional Midwest Senior Select, Inc. representative for your Life insurance needs at:

262-241-3662 or 800-251-3662

Or, please complete the following form, and submit your information. You will be contacted by one of our authorized licensed Life insurance representatives to answer any questions and give you comparison quotes with several Life insurance companies.

Name*
First Last
Email*
Home Phone
Day Time Phone
Address*
Street Address Address Line 2 City State ZIP Code
Quote Information
Who is this quote for?*
Has the applicant ever been declined or rated for life insurance?*
- Yes
- No
Applicant Information
Age*
Gender*
Smoker/Non-Smoker*
Marital Status*
Insurance Type*
Insurance Amount*
Term Length (if applicable)*
Brief Health Survey
Do you take any medication?*
- Yes
- No
Please list any medications or health issues.
Please list any general comments, questions, or concerns.

Universal Life Insurance

Get Peace of Mind!

Let us help you navigate your life insurance options!

262-241-3662 or 800-251-3662

Quote Information

Applicant Information

Brief Health Survey