LIFE INSURANCE

Purchasing life insurance can help ensure short and long term financial obligations can be met if the unforeseen should happen.

A quick 5-question application process for members age 59 and under means it is easier to apply for term life insurance. If we find no further medical information is needed upon review of your application, then you’re done! It’s as easy as that.

• You may apply for up to $250,000 if you are age 39 and under
• You may apply for up to $150,000 if you are age 40 to 49
• You may apply for up to $100,000 if you are age 50 to 59

If you’re age 64 and under or would like up to $2,000,000 of coverage, you may apply by completing a full application.

To read our life insurance FAQs, click here.

Please return your completed application to:
The TDA Insurance Agency, Inc.
6505 Lee Highway
Chattanooga, TN 37421
Email: TDA@assoc-admin.com
Fax: 866.791.2806

Interested in seeing some quotes before making your decision to apply? Simply fill out the form below, and we’ll return your quotes to you shortly – no obligation.

Name:

Date of Birth:

Gender:

• Male
• Female

Residence Address:

Residence City:

Residence State:

Residence Zip Code:

Phone:

Email:

Preferred Method(s) of Contact:

• Phone
• Email
• Mail

Have you ever used tobacco or other nicotine products in any form (including e-cigarettes, vaping, nicotine gum, or hookah)?

• Yes
• No

Date Tobacco or Other Nicotine Products Last Used:

Adverse Health History:

Height:

Weight:

Amount of Coverage Desired:

• $100,000
• $250,000
• $500,000
• $750,000
• $1,000,000
• $2,000,000
• Other

Other Amount:

Term Length Desired:

• 10 Years
• 20 Years
• 30 Years

Submit