Our online applications are the fastest, easiest way to apply for coverage. You can get a quote in minutes, with no obligation to apply.
- Term Life Insurance
- Critical Illness Insurance
- Accidental Death & Dismemberment Insurance
Please note if you do not have existing coverage under this policy you will need to provide credit card information if you wish to submit your application electronically.
Print an Application
Please note you will need Adobe Acrobat Reader, available free from Adobe, to view and print the application form.
Request an Application
To request an application: Email Industrial Alliance at firstname.lastname@example.org or call 1 (800) 266-5667 for any of the above products.