Submit Your Term Life Business Online with...
Submit your "Term Life Request for Insurance Form" online, (or download forms, complete and FAX to The Thompson Agency at 860-693-4547). Company teams contact the applicant to get details, order a Paramed and additional requirements. Save time, reduce the need for additional requirements and simplify your client's experience with FastApps. See below to get started.

Banner's AppAssist program allows you to submit your business in two ways:
Option #1: Click here
to submit online.
Option #2:
(a) Click here to download and print applicant instructions
(b) Click here
to download forms...
(c) ...complete forms and fax to: The Thompson Agency at 860-693-4547
Coverage Guidelines
AppAssist program face amounts are limited to coverage amounts below: Banner's call center representative will complete the application part II and order any required exams or reports.
|
Issue Age |
Coverage Amount |
|
< 70 |
Up to $3,000,000 |
|
71 & Older |
Up to $500,000 |
Coverage amount includes:
- The face amount currently being applied for; PLUS
- The face amount (including rider amount) of all existing policies
with Banner Life

Paper forms with fax submission:
(a) Click here to download and print applicant instructions
(b) Click here
to download forms...
(c) ...complete forms and fax to: The Thompson Agency at 860-693-4547
Coverage Guidelines
AppAssist program face amounts are limited to coverage amounts below: William Penn's call center representative will complete the application part II and order any required exams or reports.
|
Issue Age |
Coverage Amount |
|
< 70 |
Up to $3,000,000 |
|
71 & Older |
Up to $500,000 |
Coverage amount includes:
- The face amount currently being applied for; PLUS
- The face amount (including rider amount) of all existing policies
with William PennLife
Life Quick Request
Genworth's Life Quick Request program allows you to submit your business in two ways:
Option #1: Click here
to submit online.
Option #2: Click here
to download forms, complete... ...and fax to: The Thompson Agency at 860-693-4547
Both options request basic information - client name, address, phone number, and a few questions about the level premium period, beneficiary, reason for insurance, nicotine use, billing frequency and if one or more policies are being replaced.
Genworth's fulfillment center will complete the process. They'll contact the applicant to get all the details and your clients can voice-sign the needed authorizations. While on the phone, they'll schedule a paramed. Later, Genworth fulfillment will order additional requirements if needed.
Improve issue time, Reduce the need for additional requirements and Simplify your customer's experience with Life Quick Request.
Questions? Contact Us >>

The Hartford's Request for Term Insurance Application
program requires FAX submission:
Click here
to download forms, complete and fax to:
The Thompson Agency at 860-693-4547
What Happens Next?
The Hartford will take from there. Your client will be interviewed by phone and the application will be completed. Underwriting Requirements will be ordered and you will be kept informed of the case status.
Questions? Contact Us >>

Prudential's Xpress Quick Form process:
FAX Submission is Required for Face Amounts under $250,000
(not to be used for juvenile applications & not available in MA, NJ, NY, VT)
Click here
to download forms, complete and fax to:
The Thompson Agency at 860-693-4547
What Happens Next?
Prudential will take from there. Your client will be interviewed by phone and the application will be completed. Underwriting Requirements will be ordered and you will be kept informed of the case status.
Questions? Contact Us>>

West Coast Life's EZ-App & TeleLife allow you to submit in two ways:
EZ-App: Click here
to submit online.
TeleLife: Click here
to download forms, complete and fax to:
The Thompson Agency at 860-693-4547
Both options request basic information - client name, address, phone number, and a few questions about the level premium period, beneficiary, reason for insurance, nicotine use, billing frequency and if one or more policies are being replaced.
West Coast Life will complete the process. They'll contact the applicant to get all the details and your clients can voice-sign the needed authorizations. While on the phone, they'll schedule a paramed. Later, WCL will order additional requirements if needed.
Improve issue time, Reduce the need for additional requirements and Simplify your customer's experience with Life Quick Request.
Questions? Contact Us >>