Disability Buy - Out Insurance

Provides dollars for the purchase of an Ownership Interest and an Orderly Transfer When a Lengthy Disability Removes an Owner from the Business.

The loss of the services of one of the Active Owners of a Business will place a substantial burden upon the remaining working owners.

Disability Buy-Out Insurance is designed to help provide funds toward the purchase of a disabled partner's ownership interest when, due to a lengthy disability, he or she is longer capable of being a productive member of the team.

By purchasing Disability Buy-Out Insurance before disability strikes, the business can provide a solution to one of the most difficult dilemmas that any business is likely to ever have to face.

Benefits begin after 12, 18, or 24 Months of Total Disability in accordance with the terms of the Buy-Out Agreement.

Benefits may be paid either in a Lump Sum, or in Monthly Installments over 12, 24, 36, 48, or 60 Months, or some Combination of lump sum with installments.

For more information on Disability Buy-Out Insurance, or for a Proposal for one of your better clients please complete our Questionnaire which follows:

Disability Buy-Out Quote Form

Broker Submitting Quote Request:
First Name: City
Last Name: State
Company: Zip
Street Address 1: Phone#:
Street Address 2: Fax#:
Clients Name:  
Date of Birth:  Age:  
State of Residence: State of Employment:
Is this client a smoker ?    


Exact duties of client :  

Does this client have any Disability Income Coverage presently in force? (Individual or Group)?              

If  Yes, please give details (amount and coverage)

Reported Income for Previous Year: 

Reported Income two years ago (if known)

What is the Total Value of the Business?

What is the Percentage of the Business Owned by this Individual

Waiting Period:

Benefit Payable in a Lump Sum:  
Benefit Payable in Monthly Installments Over:


Please tell us about each of the Active Owners of the business by completing a Questionnaire for each individual.

How do you want the results sent to you by: 

Mail    Fax   E-Mail 

If necessary we may contact you for additional
information before preparing your proposal.

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