Skip to content
Why Your Money Back Insurance?
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
YOUR FEED-BACK IS OUR CONCERN...
YOUR MONEY-BACK IS OUR MISSION!
Would You Agree It's A Win-Win? You Receive Your Check If You Use Your Policy, You Receive Your Check If You Don't. Which Example Would You Prefer?
Example A
Example B
Example C
Wouldn't It Be Great, If All Insurance Policies Behaved This Way?
Yes
No
To See If You *Qualify, Please Complete The Following:
Smoker / Non Smoker ?
Non-Smoker of ANY KIND in past 12 months
Smoker of cigarettes in past 12 months
Medicinal Use of Marijuana in past 12 months
Recreational Use of Marijuana in past 12 months
Name
*
First
Last
Address
*
You Use Check
Date of Birth
*
Phone Number
*
Email
*
Submit