Life Asset Group


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HEALTH (if this is a joint policy please use the health status of the healthiest individual)

What is the insured's current medical condition?

Very healthy/Preferred = 0 pts
Healthy Senior with minor health problems/Standard = 5 pts
Some health problems/Slightly Rated (Tables 1 to 4/up to 200%) = 10 pts
Moderate health problems/(Table rated 5-18/200%-500%) = 15 pts
Significant health problems/Rated 16 or higher, greater than 500%, or uninsurable) = 20 pts

Has the insured's current medical condition changed significantly since the policy has been issued?

The insured’s medical condition has improved = 0 pts
The insured’s medical condition has stayed the same = 5 pts
The insured’s medical condition has worsened = 10 pts

PREMIUM
What is the annual premium?

Greater than 8% of the Death Benefit = minus 5 pts
6%-8% of the Death Benefit = 0 pts
4%-6% of the Death Benefit = 5 pts
2%-4% of the Death Benefit = 15 pts
Less than 1.9% of the Death Benefit = 20 pts

Is the client seeking new coverage?

Yes = 0 pts
No = 5 pts

AGE AND GENDER
What is the insured's age and gender?

Male under 60 or Female under 60 = minus 30 pts
Male 60-64 or Female 60-64 = minus 15 pts
Male 65-70 or Female 65-73 = 5 pts
Male 71-77 or Female 74-80 = 10 pts
Male 78-83 or Female 81-85 = 15 pts
Male over 84 or Female over 86 = 20 pts

POLICY INFORMATION
What is the policy type?

If the policy is a whole life and has a cash value greater than 50% and/or loans greater than 30% = minus 5 pts
Non-Convertible Term = 0 pts
Whole Life = 5 pts
Convertible Term = 5 pts
Survivorship policy with both insured's alive = 10 pts
Universal Life or Survivorship with one insured deceased = 15 pts

What is the policy's face value minus the cash surrender value?

Less than 100K = minus 30 pts
100K-250K = minus 10 pts
250K-500K = 5 pts
500K-1 Mil = 10 pts
1 Mil-5 Mil = 15 pts
Greater than 5 Mil = 20 pts

Total Score: ___________

Scoring:
49 pts or less = Case not viable, please close
50 pts or greater = Very likely Life Settlement case

Insured Name:
Policy Issue Date:
Policy's Maturity age, (including riders):
Name of Submitting Agent:
Agent's phone number:
Agent's email address:

*IN TEXAS, D/B/A LAG SETTLEMENTS, LLC (See also Important Limitations in Texas)

Life Asset Group, LLC and/or Gary E. Brecka, as an individual, are licensed as a life settlement broker or viatical settlement broker in the following regulated states.

Gary E. Brecka, individually, can broker a life insurance policy owned by a resident of the following states: AR, CO, FL, GA, IN, KS, KY, LA, MD, ME, MS, MT, NV, NC, NJ, OK, PA, TN, TX, UT, VA.

Life Asset Group, LLC, as a licensed entity, can broker a life insurance policy owned by a resident of the following states: AR, CT, FL, LA, MD, ME, NV, NJ, OH, PA, TX, VA.

Depending on the medical condition of the insured, Life Asset Group, LLC and/or Gary E. Brecka, as an individual, may or may not be able to broker a life insurance policy owned by a resident of the following states: CA, DE, IL, MA, MN, NM, NY, OR, VT, WA, WI.

Life Asset Group, LLC and/or Gary E. Brecka, as an individual, may broker a life insurance policy owned by a resident of the following states that are not regulated and do not require licensure: AL, AZ, DC, HI, ID, MI, MO, NH, RI, SC, SD, WY.

Life Asset Group, LLC is in the process of becoming licensed in the following states: AK, PR.

This Compliance Notice is current as of May 21, 2008 and is subject to change.