1. Has any Proposed Insured been diagnosed with or treated for Human Immunodeficiency Virus (HIV), Acquired Immune Deficiency Syndrome (AIDS), or Aids Related Complex (ARC) or AIDS related condition?
2. Has any Proposed Insured been advised by a medical professional to undergo treatment, futher diagnostic evaluation or testing, or recently had diagnostic test performed where the results are still pending or were incomclusive for any medical condition?
3. Has any Proposed Insured ever been diagnosed with, treated for, or advised to have treatment for any disease, disorder, or abnormality of the heart or circulatory system?
4. Has any Proposed Insured ever been diagnosed with, treated for, or advised to have treatment for carotid artery disease, peripheral artery disease, cerebrovascular disease, stroke, or TIA (Transient Ischemic Attack)?
5. Within the past 6 months, has any Proposed Insured had 2 or more blood pressure readings of 140/90 or above?
6. Has any Proposed Insured ever been diagnosed with diabetes?
Thank you for applying, last part is when you would like payment to be done.
Created with