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Qualifying Questionnaire

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Qualifying Questionnaire
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Use the questionnaire below to determine the probability of a life settlement.
 

Client’s Age and Sex:

 

 

 

1 Point

Male age 65 - 74 / Female age 65 - 77

 

 

 

2 Points

Male age 75 - 78 / Female age 78 - 81

 

 

 

3 Points

Male age 79 - 83 / Female age 82 - 86

 

 

 

4 Points

Male age 84 + / Female age 87 +

Medical Condition:

 

 

 

1 Point

Healthy senior

 

 

 

2 Points

Has a minor health problem

 

 

 

3 Points

Health has changed considerably since policy was issued

 

 

 

4 Points

Client has developed a serious illness

Type of Policy:

 

 

 

1 Point

Joint Survivorship or Whole Life

 

 

 

2 Points

Convertible Term Life

 

 

 

3 Points

Universal Life

 

 

 

4 Points

Joint Survivorship with one deceased

Current Cash Surrender Value of the policy as a percentage of the net death benefit:

 

 

 

1 Point

30% +

 

 

 

2 Points

20% - 29%

 

 

 

3 Points

10% - 19%

 

 

 

4 Points

0%   -  9%

Outstanding loans as a percentage of the net death benefit:

 

 

 

1 Point

30% +

 

 

 

2 Points

20% - 29%

 

 

 

3 Points

10% - 19%

 

 

 

4 Points

0%   -  9%

Annual premiums as a percentage of the net death benefit:

 

 

 

1 Point

4.00% - 4.99%

 

 

 

2 Points

3.00% - 3.99%

 

 

 

3 Points

2.00% - 2.99%

 

 

 

4 Points

1.00% - 1.99%

 

Total:

 

 

 

 

Life Settlement Prospect:

 

0 - 6

 

It is highly unlikely client/policy would qualify.

 

7-12

 

It is unlikely client/policy would qualify.  Please call Estate Trust to discuss.

 

13 -18

 

Client/policy will probably qualify.  Recommend an application be submitted.

 

19 -24

 

Client/policy qualifies.  Recommend an application be submitted.

   
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   ESTATE TRUST, INC.®

7400 York Road, Suite 300

Baltimore, Maryland  21204

410-828-1171;  800-456-5100