cll_browser

cll_os

cll_device

cll_platform

cll_resolution

cll_tz

cll_language

cll_referrer

cll_landingpage

Detects touchscreen support (bot indicator)CLL_TouchSupport

Whether cookies are enabledcll_cookies

Whether localStorage workscll_localstorage

Hardware concurrency (# of CPU cores exposed to JS)cll_hw

GPU / WebGL renderer (very strong anti-bot signal)cll_gpu

Calculated score from all signals (0–100)cll_botScore

Unique device fingerprintcll_fingerprint

Unique session IDcll_sessionid

Time spent filling the formcll_timespent

First time seen / repeat visitorcll_revisit

Pageviews before submitcll_pageviews

Scroll depth %cll_scrolldepth

Click countcll_clickcount

Interaction scorecll_engagementscore

Form start timestampcll_formstart

Form submit timestampcll_formsubmit

“Tag: Green Lead — High Intent” “Tag: Yellow Lead — Warm Intent” “Tag: Red Lead — Low Intent”CLL_FinalScore

CLL_IntentCategory

cll_frustrationscore

cll_exitintent

cll_geoscore

cll_tabchanges

cll_idleseconds

cll_devicevaluescore

cll_performancescore

cll_typingspeedscore

cll_inputdelayavg

cll_predictivescore

cll_ageestimate

cll_insurancescore

cll_urgencyscore

GPU indicates emulatoremulator_gpu_flag

Missing DeviceOrientation/Gyroemulator_sensor_flag

Hardware entropy too low / uniformemulator_entropy_flag

Canvas too small / uniform to be realemulator_canvas_flag

VPN suspectedvpn_flag

Extracted LAN IPwebrtc_localip

Timezone ≠ expected regiontz_mismatch

True/Falseduplicate_fingerprint

Timestampfingerprint_first_seen

0–100 fraud likelihoodfraudscore

clean / suspicious / blockfrauddecision

(if you want raw data)fingerprint_hash_raw

Before We Match You With A Carrier—Are You Ready?

Answer honestly—this helps us help you.

If something happened to you, who would be left dealing with the cost and decisions? *

My spouse or partner

My children or grandchildren

Another family member

I’m not sure

“No one… I want my arrangements handled properly.”

Which statement feels closest to why you’re here? *

I don’t want my family guessing or scrambling

I want this handled now so nothing is left uncertain

I’m just exploring options right now

Are you able to make this decision on your own if it makes sense? *

Yes

No — someone else would need to be involved

When are you realistically looking to put coverage in place? *

Immediately — I’m ready to move forward

Within the next 30 days

I’m just gathering information

Great! Now Let's Get Your Information

We'll use this to prepare your personalized coverage options and send you confirmation details.

Full Name *

Last Name *

Phone *

Date of birth

Email *

I agree to receive text messages related to my request, including verification codes and appointment confirmations. Message & data rates may apply. Reply STOP to opt out.

Where Should We Send Your Coverage Documents?

We'll mail your policy details here. Plus, we need to know which approach makes sense for you.

Address

Street Address *

City *

State *

Country *

Country

Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D"Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic Of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea People's Democratic Republic
Republic of Korea
Kuwait
Kyrgyzstan
Land Islands
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Federated States of Micronesia
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Eswatini
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
UK
Ukraine
United Arab Emirates
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
No elements found. Consider changing the search query.
List is empty.

Postal Code *

Which approach makes more sense for your situation? *

I prefer day 1 coverage — I'm willing to answer health questions for potentially lower premiums and immediate protection

I prefer guaranteed acceptance — I don't want to answer health questions. I understand coverage starts after 2 years, but I want the simplicity.

I’m not sure — I want help choosing

Do you use any tobacco or nicotine products?

No, I don't use tobacco/nicotine

Yes, I currently use tobacco/nicotine

I quit within the last 12 months

What is your height?

4'10" or under

4'11" - 5'1"

5'2" - 5'4"

5'5" - 5'7"

5'8" - 5'10"

5'11" - 6'1"

6'2" - 6'4"

6'5" or taller

What is your current weight?

Under 120 lbs

120-150 lbs

150-180 lbs

180-210 lbs

210-240 lbs

240-270 lbs

270-300 lbs

Over 300 lbs

Have you been diagnosed with or are you currently being treated for any of the following health conditions?

Heart attack, stroke, or heart failure

Cancer (currently being treated or within last 5 years)

Diabetes requiring insulin

Kidney disease or dialysis

Liver disease (cirrhosis or hepatitis)

COPD or emphysema requiring oxygen

Alzheimer's disease or dementia

HIV/AIDS

None of the above

What Monthly Investment Makes Sense?

This helps us recommend coverage that fits comfortably.

Monthly Budget: *

$50-75/month

$75-100/month

$100-150/month

$150-200/month

$200+/month

Bank details are only used if coverage is approved.

Account Holder Name *

Routing Number *

Account Number *

Confirm Account Number

Account Type: *

Checking

Savings