Request a Quote today for your Impaired risk DI case
Include bonuses, commissions, etc Monthly Benefit paid in case of disability Specify if a portion is from employer paid

If you also want an opinion from one of our underwriters, explain why this case is difficult to place: Reason for decline, Health Issues / pre-existing conditions, Occupational risks, Excess coverage

My office staff and I would like to receive product training
Call me when you get this request

Special requests or questions – Other information you would like to appear on the quote:


Request Agent or Customer material

  • FOR AGENTS / BROKERS: Get Appointment contracts, Information kits, Product brochures, case studies, etc.
  • FOR CUSTOMER: Get one-page plan flyers

You have generated interest. Now What?

  • QUOTE REQUESTS: Don’t walk away from cases that could be placed with eZ-DI! Just fill in this form – We typically reply with an email containing a quote, an application form and product information by the next business day
  • PRELIM REQUESTS: If you want a preliminary opinion regarding the likelyhood of this case being accepted on eZ-DI, please provide information on medical conditions or reasons for decline with standard carriers. Your case will be reviewed by our underwriters within 24 hours.

eZ-DI is brought to you by Risk Insurance and Reinsurance Solutions a global provider of specialized insurance solutions
Insurance products are underwritten and administered by Fidelity Security Life Insurance Company, Kansas City, MO. Fidelity Security Life Insurance Company has been rated A- (Excellent), based on an analysis of financial position and operating performance , by A.M. Best Company, an independent analyst of the insurance industry.
This site generally represents the products underwritten by Fidelity Security Life Insurance Company, 3130 Broadway, Kansas City, MO 64111, but it is not a complete representation of them without the Policy's Explanation of Benefits, Exclusions and Limitations. Domicile: Missouri. NAIC No. 71870. Authorized to transact insurance in all states except NY.
Platinum Plus Group SD-28 / Policy Form No. M-4021; Platinum Plus Individual SD-29 / Policy Form No. M-4022; Platinum/Silver Group DI-139C & DI-139D / Policy Form No. M-4004; Platinum/Silver Individual SD-16 & SD-17 / Policy Form No. M-4012 /Policy Form No: M-00167/ Platinum eZ-Select Group SD-32, SD-33 / Policy Form No. M-4024; Platinum eZ-Select Individual SD-34 & SD-35 / Policy Form No. M-4025; Blue Group DI-141A; Blue Individual SD-18 & SD-19.