Kristie Carlsen is MVP’s Director of Underwriting. To help her more accurately review your case, please complete the appropriate form below!
Call Kristie at (847)901-4500.

You may also email your underwriting questions to mvpinfo@mvp4me.com. Fax to your local MVP office.

Quote the Right Class the First Time – Complete this General Info Underwriting Criteria Questionnaire or one of the specific impairment questionnaire’s below.

 Alcohol Drugs Pancreatitis
 Angioplasty Eating Disorders Panhypopituitarism
 Anxiety Disorders Emphysema Paralysis
 Arthritis Enlarged Heart Parkinson’s Disease
 Atrial Fibrillation Epilepsy Personality Disorders
 Aviation Foreign Travel Residence Pheochromocytoma
 Avocations General Use Questionnaire Polycystic Kidney Disease
 Build Glomerulonephritis Polyp, Cyst, Tumor or Growth
 Bundle Branch Block Heart Attack Myocardial Infarction Prostate Benign
 Cancer Heart Failure Proteinuria
 Cancer-Bladder Heart Murmur
 Cancer-Breast Hemochromatosis PSA-Elevated
 Cancer-Cervical Hepatitis Sarcoidosis
 Cancer-Ovarian Hypercoagulable Disorder Scleroderma
 Cancer-Prostate Hyperglycemia Seizure Disorder
 Cancer-Skin Hypertension Sickle Cell Anemia
 Cancer-Testicular Irregular Heartbeat Sleep Apnea
 Cerebral Palsy Kidney Function Tests Spinal Cord Injury Plegic
 Congestive Heart Failure Kidney Transplant Stent
 COPD Leukemia Stroke, TIA
 Coronary Artery Disease Liver Tests T Wave Changes
 Coronary Bypass Lung Disease Thrombus
 Crohn’s Disease Lupus Thyroid Disease
 Cushing Syndrome Lymphoma Valvular Heart Surgery
 Dementia-Alzheimer’s Mental Disorders
 Depression Mitral Valve Disorder Prudential Rx for Success: Marijuana
 Diabetes Multiple Sclerosis
 Down Syndrome/Intellectual Disability Neuromuscular Disorder Banner’s InTOUCH Underwriting Microsite
 Driving Pacemaker
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