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Life Insurance Needs Analysis


Life Insurance Needs Analysis Form
Please use this form to calculate your life insurance needs. You may fill out this form and submit it by pressing the submit key, or you may print the form by using file/print on your browser.
*Denotes required field for electronic submission. Thank you!
Insured
Your Full Name: *
EMail Address: *
Cash Needs
1. Immediate money fund: To pay bills presented after death such as medical and hospital expenses, funeral expenses, attorney and executor fees, federal estate taxes and probate court costs.
2. Debt Liquidation: Amount needed to pay installment credit, school and auto liens and bills.
3. Emergency fund: For unexpected bills not payable from current income; auto or home repairs, medical bills.
4. Mortgage/Rent Payment Fund: Some families plan to pay off the mortgage if the insured person dies so the survivors have a debt-free home.
5. Child/Home Care Fund: To pay for new expenses created as a result of the death of a spouse formerly performing these duties without any cash outlay.
6. Education Fund: The costs of a four-year undergraduate degree vary but $20,000 per child is usually the minimum that should be provided.
7. Subtotal: Add lines 1 through 6.
8. Available Assets: Such as savings and existing life insurance, including amount provided by employer.
9. Cash needs requirement: Subtract line 8 from line 7.
Income Needs
1. Income Replacement: Designed to provide the dependent spouse with a fixed income until retirement. Fifty-Seventy percent of annual take-home pay times the number of years until retirement.
2. Cash Requirements: Amount from line 9 "Cash Needs" Section. Note if negative amount.
3. Total Cash Needed: Add lines 1 and 2.
4. Other Assets: Cash, savings, checking retirement funds, existing life insurance, investments, value of your home, business, real estate and other property not included in line 8 of "Cash Needs" section.
5. Total cash needed minus assets: Line 3 minus line 4.
Your potential life Insurance Needs: From line 5.
Press when finished




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This page was last updated May 05, 2002