Stier Financial

    Phone: (403) 571-6020
    Toll Free: 1-800-267-9606
Dealing Representative of
pennantcapital

Stier Financial Group Inc.

Suite 201, 10820 24th Street SE
Calgary, Alberta, Canada
T2Z 4C9

Phone:(403) 571-6020
Toll Free: 1-800-267-9606

Insurance Services
Request to Quote for Critical Illness Insurance

Please fill out this form and submit it to our offices to request a free quote for insurance.
(*) signifies mandatory fields which must be completed prior to submission of the form.

General Information

Name (*)
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Address (*)
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City (*)
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Province (*)
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Postal Code
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Phone Number (*)
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Fax Number
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E-mail Address (*)
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General Questions

Gender (*)
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Date of Birth (mm.dd.yyyy) (*)
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Select the amount of coverage you would be interested in (*)
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Used any tobacco products in the last 12 months? (*)
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What is your yearly income? (*)
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How would you like to pay? (*)
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Available Riders and Options

Return of Premium at Death (*)
Please select return of premium at death
Waiver of Premium on Disability (*)
Please select waiver of premium on disability
  

Definitions:

Return of Premium at Death

If the insured dies without qualifying for the Covered Condition Benefit, this rider returns premiums paid for by the associated coverage.

Waiver of Premium on Disability

After the insured is disabled for 90 consecutive days, the premiums will be paid for by the insurance provider while the insured is disabled.

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