Apply

Once you've determined the right amount of life insurance for your needs, taking the next step with Simple Issue Term is easy. Just follow our fast, convenient and hassle-free application process to begin protecting your family's financial future.		  
     
  Step 1
Choose your state of residence. Please note that Simple Issue Term is not available in all states and territories of the United States. If your state is not listed, Simple Issue Term is not available in your area at the present time. For more information on availability, contact us.

 
  Step 2
Download, complete and sign an Application for Coverage.

The application can be opened and printed using Adobe Acrobat Reader. To download a free version of Adobe Acrobat Reader , click here to get Reader. Please use a pen to complete the application.

Please remember to review the policy disclosures prior to completing and downloading an Application for Coverage.

 
  Step 3
Submit your premium payment, along with the completed and signed application to:

Individual Assurance Company, Life, Health & Accident
2400 West 75th Street
Prairie Village, KS 66208

If you choose the monthly payment option on the application, send a check for your first monthly premium, using the rate table at the bottom of the application to determine the amount. Also, forward a voided check as explained on the application to begin bank authorized direct debits for future monthly payments.

If you choose the annual payment option on the application, send a check for the full annual premium, multiplying the monthly rate from the table at the bottom of the application by eleven. By paying your premium annually rather than monthly, you receive a one-month discount each year.

 
     
  Step 4
If your application for coverage is approved based on the information you provide, your policy will be issued and mailed to you. Please allow three days for processing once we receive your application, plus mail delivery time. Monthly payments will be deducted through a bank authorized direct debit from the account you specify on your application. The initial direct debit will begin on the date you selected on the application in the month following the issuance of your policy. If you choose the annual payment option you will receive a premium notice thirty days prior to the anniversary date of your policy with instructions on where to send your payment.

If your application is denied, you will receive a letter of explanation issued within three days following receipt of your application.

 
     
  Need Assistance?
For questions on the application process, or help with downloading files, visit the Help section of this site or call Individual Assurance Company at 800.821.5434.