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a fast and convenient process to purchase disability income insurance
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What Happens Next?
Simply choose your benefit amount and complete our online application. The whole process can be done in less than 10 minutes. You can also call one of our Disability Insurance experts at your convenience.
Insured's Information
Date of Birth
Gender
--Select One--
Male
Female
Resident State
--Select One--
Alabama
Alaska
Arizona
Arkansas
Colorado
Connecticut
Delaware
District of Columbia
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Tobacco Use
--Select One--
Yes, I use tobacco products
No, I do not use tobacco products
% Manual Duties
×
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Manual Duties
You must specify the percentage of time you spend performing manual duties. All active duties performed in all occupations should be considered.
Manual duties means any physical activity including, but not limited to: standing, walking, stooping, bending, pushing, pulling, lifting, carrying, climbing, crawling, kneeling and driving a vehicle.
--Select One--
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Select Your Coverage
Annual Income
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Annual Income
The minimum annual income supported is $18,000
Annual income includes salary, bonuses, commissions and other monetary compensation (net of expenses for business owners and self-employed individuals).
Benefit Amount
--Select One--
$25,000
$30,000
$35,000
$40,000
$45,000
$50,000
$55,000
$60,000
$65,000
$70,000
$75,000
$80,000
$85,000
$90,000
$95,000
$100,000
If you need protection in excess of your income or $100,000 our team of licensed agents can provide you with assistance, including providing you with a quote and completing an application.
Please click here to contact us.
Carrier
Ameritas Life Insurance Corp.
A.M. Best Rating: A (Excellent)
https://www.ameritas.com
Product
DInamic Fundamental
®
Disability Income Insurance
Income protection safeguards your financial situation by making sure money keeps coming in — even if you become too sick or disabled to work.
Click Here for Detailed Product Information
Total Premium
(Select One)
$
/ Month
$
/ Year
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