We've Got You Cover. Save On Life Insurance Today! Here we will collect personal data to give you the best quote.Do you currently have life insurance? *YesNoWhat is your gender? *Choose OptionMaleFemaleDate of Birth? *You may only signup for a policy from 18 years old and above.Are you a tobacco smoker? *YesNoDo you drink alcohol? *YesNoDo you do any high risk sports or hobbies? (E.g. rock climbing, skydiving, motorsport) *YesNoDo you travel to high-risk regions? (E.g. Middle East, Eastern Europe, North and Central Africa, South America) *YesNoSubmit Financial, Education, Marital Status Data We close to getting you covered with life insurance.What is you education level? *High SchoolSome CollegeUniversity DegreeNone of the aboveWhat is your occupation? *Choose level of occupationEntry LevelManagement LevelExecutive LevelProfessionalRetiredSelf EmployedNone of AboveWhen did you start working at your current job? *Rate your occupations level of stress? *Low stressful levelSometimes stressfulIt gives me high blood pressure at timesNone of the aboveWhat is you residency status? *Choose OptionRentOwnOtherHow long have you been living here? *What is you marital status? *MarriedSingleDivorceWidowedWhat is your household income? *$20,000-$40,000$40,000-$70,000$70,000-$100,000$100,000 AboveIncome Status? *Choose OptionSingle IncomeJoint IncomeOther (Dividends/Investments)We need information about your health Here will look at your physical and family history.How many days do you exercise per week? *Two days per weekThree days per weekFive days per weekSix days per weekI do not exerciseI exercise only when I feel like itWhat is your height (Foot) *What is your weight (lbs./kg)? *What is your weight type? *Choose OptionPounds (LBS)Kilograms (KG)Have any of your immediate family members had cancer, heart disease, stroke, or an aneurysm before the age of 70? *YesNoHave you been treated for a major condition in the last five years? *I have no medical conditionsCancerDepressionHeart DiseaseAlcohol or drug abuseCOPDDiabetesOther serious condition Congratulations! You've been approved for our Life Insurance Products. Let's collect information about your main policyholder and main beneficiary. What we need in the next step: First and last name Address Email Phone number Upload identification documents of main policyholder and main beneficiary. (passport, driver's license, or government identification document(ID) - any one of these documents must show your first and last name). We need one of these documents to prove you are the owner of the policy and that the beneficiary is a real individual. This is also required by law and for KYC purposes (Know Your Customer). Soon you will have LIFE INSURANCE COVER. Let's get started! Before we go, let's get your contact detailsPolicyholder DetailsPlease enter the details of the main policyholder.Name *Last Name *Email *Initials *Phone Number *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweUpload fileChoose FileNo file chosenDelete uploaded fileUpload Passport/Drivers License ID/Government Approved ID (We need this for KYC purposes)SSN/Passport/Government ID/Drivers License Number *Please select government identification type *Choose OptionPassportSocial Security Number (SSN)Government Identification (ID)Drivers LicenseCountry *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweWhich country issued this document?Main Beneficiary DetailsPlease enter the details of the main beneficiary.Name *Last Name *What is there gender? *Choose OptionChoose genderMaleFemaleDate of Birth? *Email *Phone Number *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweUpload fileChoose FileNo file chosenDelete uploaded fileUpload passport/Drivers License ID/Government Approved ID (We need this for KYC purposes)Relation to you? *Choose OptionChildPartner (Wife/Husband)ParentDependentFamilyFriendRevocable or irrevocable *Choose OptionRevocableIrrevocableLet's Get You Life Insurance Cover Here we will collect cover details and pay for your policy.Choose type of life insurance cover *Choose OptionChoose option$1,000,000 (+Survival Benefit: $100,000 – $500,000)$5,000,000 (+Survival Benefit: $500,000 – $2,500,000)$10,000,000 (+Survival Benefit: $1,000,000 – $5,000,000)Choose the length of your $1,000,000 life insurance cover10 Year Single Premium Fee $13,500 (+ Survival Benefit: $100,000) Savings $1,50020 Years Single Premium Fee $22,500 (+ Survival Benefit: $250,000) Savings $2,50030 Years Single Premium Fee $31,500 (+ Survival Benefit: $500,000) Savings $3,500Single Premium Fee is the once-off cost for the period of the policy.Choose the length of your $5,000,000 life insurance cover10 Year Single Premium Fee $49,500 (+ Survival Benefit: $500,000) Savings $5,50020 Years Single Premium Fee $112,500 (+ Survival Benefit: $1,250,000) Savings $12,50030 Years Single Premium Fee $225,000 (+ Survival Benefit: $2,500,000) Savings $25,000Single Premium Fee is the once-off cost for the period of the policy.Choose the length of your $10,000,000 life insurance cover10 Year Single Premium Fee $135,000 (+ Survival Benefit: $1,000,000) Savings $15,00020 Years Single Premium Fee $225,000 (+ Survival Benefit: $2,500,000) Savings $25,00030 Years Single Premium Fee $450,000 (+ Survival Benefit: $5,000,000) Savings $50,000Single Premium Fee is the once-off cost for the period of the policy.Consent *By accepting the policy, you acknowledge and agree to the terms of the Life Insurance policy outlined herein. You affirm that all information provided throughout the application process is true and accurate to the best of your knowledge. Please note that the single premium payment for this policy will be the responsibility of the main policyholder listed on the account and must be made promptly upon policy activation. Additionally, any updates or changes to the policy should be communicated directly to the insurer for proper documentation and processing. You agreeing to the policy indicates your understanding and acceptance of the terms of policy.Policy Acknowledgment *I hereby confirm my application submission to Insurance by Tryllian, (The insurance arm of Tryllian Corporation) for an Insurance Policy. The underwriter/issuer, ALGHMF Corp, ALGHMF LLP, ALGHSA ("Company"), provides Guaranteed Life Insurance. As the policyholder, I have thoroughly reviewed the provisions delineating the performance expectations of a life insurance policy, based on the company's assumed return rates. I am also cognizant of the potential variability in the performance of the insurance fund, understanding that the values of my units are subject to variable change and not guaranteed. Such values will hinge upon the actual performance over any given period, potentially resulting in a policy value lower than the premiums paid. Policy closure can expose policyholders to various risks, including those influenced by external economic factors such as war, inflation, and recession. In times of war, political instability can disrupt financial markets, potentially leading to a decrease in the value of investment assets held within the policy. Similarly, periods of high inflation can erode the purchasing power of the policy's returns, reducing its overall value. Additionally, economic recessions may adversely affect the performance of the insurance fund, resulting in lower returns or even losses for policyholders upon closure. These external factors underscore the importance of carefully considering the timing and implications of policy closure to mitigate potential financial risks. I acknowledge that the risks associated with this policy are mine to bear as the policy owner.Consent *Yes, I agree with the privacy policy and terms and conditions.Full Name of Applicant *The full name will be used to sign and accept the policy.Date signed and accepted *Time of policy acceptance *HoursMinutes Total Single Premium$Single Premium Life Insurance (SPL) offers coverage through a one-time upfront payment instead of recurring premiums. Once paid, the policy becomes active, providing insurance for the insured.Get Insure NowSave as Draft Share this:FacebookX