Impaired & Specialty Risks

This section is designed to help producers field underwrite their clients. The more information that you can provide to us, the better we can assist you in correctly quoting your clients.  Click here for the Pre-Screen Questionnaire

Please click an impairment below and complete the back page. We do not require a client signature. Complete with as much information as possible. We will turn this into an electronic format and send it out to our top carriers. Hancock Brokerage will begin receiving tentative offers over a period of 24 -48 hours after we have submitted it to the carriers. We will take those offers and run the corresponding illustrations for you. Each carrier will view the impairments differently. They will be more favorable on some and less on others. We want to work with you, our producer, to make sure that you are meeting and managing the expectations of your client. When your client has an issue with build, diabetes or CAD, we want to help you drill down to the top carriers for your client. We specialize in the impaired risk markets.

** Please note that while we are posting many of Prudential’s forms for your reference, when the completed form is returned to us, we send it to all of our top carriers.


Confidential Fax to: 504.837.0090
Scan and E-mail to: (Ashley Fleischer)



  • John Hancock’s Underwriting Guide to Underwriting Impairments 2020

  • Transamerica Underwriting Tobacco Nicotine Majiuana


What’s in the MIB?(Medical Information Bureau)

  • Avocation Guidelines: Mountaineering, Motor Sports & Scuba Diving

    Guideline only to suggest tentative rating- complete and submit the SUPPLEMENT below for an underwriter to review.

  • AVIATION Supplement

  • AVOCATION Supplement


  • SCUBA DIVING Supplement

  • Civilian Aviation Schedule

  • Motor Vehicle Driver Ratings (MVR)

  • Military Aviation Rating Schedule

  • Non-US Resident Highlighter

  • Professional Athletes (AIG)


  • Alcohol Questionnaire

  • Drug Abuse Questionnaire

  • Marijuana Use

    Questionnaire (Go to the TOOLBOX tab and register to see the Marijuana Cheat sheet)

  • Substance Abuse General Terms


  • Aortic Valve Disorder

  • Atrial Fibrillation

  • Coronary Artery Bypass Graft

  • Coronary Artery Disease

  • Heart Failure

  • Heart Attack-Myocardial Infarction

  • Mitral Valve Disorder

  • Valvular Heart Surgery


  • Alcohol

  • Asthma

  • Austism & Aspergers

  • Barrett’s Esophagus

  • Blood Tests

  • Breast Cancer

  • Cancer General Concepts

  • Cervical Cancer

  • Chronic Lymphocytic Leukemia

  • Chronic Obstructive Pulmonary Disease (COPD)

  • Colorectal Cancer

  • Crohn’s Disease

  • Depression and Anxiety Disorders

  • Diabetes Mellitus

  • Epilepsy

  • Hepatitis A, B C

  • Kidney Function test

  • Kidney Transplants

  • Liver Tests

  • Lymphoma

  • Multiple Sclerosis

  • Ovarian Cancer

  • Parkinson’s Disease

  • Prostate Cancer

  • PSA and Prostate Disorders

  • Rheumatoid Arthritis

  • Skin Cancer

  • Sleep Apnea

  • Thyroid Cancer

  • Ulcerative Colitis

Disclaimer:  This website, and all of its contents here under, are strictly for the use of AGENTS LICENSED WITH Hancock Brokerage, LLC. This site is NOT FOR CONSUMER USE. The materials contained in this site are a conglomeration of information made available to Hancock Brokerage, LLC by insurance companies, as well as Hancock Brokerage and AimcoR’s analysis and summary of products. The purpose of the information provided on this site is to provide Hancock Brokerage’s Agents with a quick guide to products available through Hancock Brokerage. While Hancock Brokerage makes every effort to maintain the accuracy of information provided on this site, Hancock Brokerage, LLC DOES NOT GUARANTEE the accuracy of information provided on this site and is NOT RESPONSIBLE FOR ERRORS AND OMISSIONS. All information should be verified with Hancock Brokerage by the Agent using this site.