Long Term Care Insurance Lead Sample

Our long term care leads are becoming a more and more popular lead type. As the population ages, and becomes better educated about the need for long term care coverage, they are seeking rates and expert advice from agents. The internet is a natural extension for many of the prospects who request a LTC quote.

We require contact information and ask for detailed information such as DOB, spouse's DOB (if any) and a self description of health status. We also request coverage information since many consumers are shopping for the coverage when they become educated about their needs.

Our long term care lead form includes some help fields that define some of the coverage information for the person filling out the lead request.

Long term care lead sample

This quote was submitted on: 09/30/2003

CUSTOMER INFORMATION:
Name: ****
Address: ****
City,State Zip: Torrance, CA 90505
Phone: 310-****
Alternate Phone: N/A
E-mail: ****

Date of Birth: **/**//1953
Gender: Male
Tobacco User: No
Health: Average
SPOUSE INFORMATION:
Date of Birth: **/**//1954

COVERAGE INFORMATION:
Desired Daily Benefit Amount: $150
For How Long?: Lifetime
Elimination Period: 180 days
Inflation Option: CPI

ADDITIONAL COMMENTS: N/A