File # 10513
Male, 39 years old
$1,000,000 coverage, 20-year term

Health Issues
  • Seizure disorder (epilepsy) - diagnosed 26 years ago - 5 gran mal seizures - 6 petit mal seizures, each year - client feels the seizures are usually triggered by conditions of fatigue and hunger
  • Drinking Alcohol - usual history is 2 drinks each weekend, but no alcohol in recent months since his last gran mal seizure
  • Family History of Cancer - father, died of lung cancer in his 60's
  • Family History of Heart Conditions - father, developed heart disease in his 50's
Medications
  • Dilantin and Tegretol (being switched to Depakene and Zarontin)
Life Insurance Questions