Disability Insurance Quote

We offer affordable short term disability and long term disability
insurance premiums to businesses in the following Connecticut counties
and cities: Fairfield County, New Haven County, Litchfield County,
Middlesex County, New London County, Hartford County, Tolland
County, Windham County, Stamford, Norwalk, Greenwich, Darien,
Riverside, Belltown, Springdale, Round Hill, Old Greenwich, East
Norwalk, New Canaan, Glenville, Byram, Cos Cob, Mianus, North
Stamford, Glenbrook, Wilton, Weston, Long Ridge, Noroton, West
Norwalk, Westport, High Ridge, Southport, North Wilton, Winnipauk,
Cannondale, Turn of River, South Wilton, Lyons Plains, Georgetown,
Ridgefield, Branchville, Redding, Topstone, Ridgebury, Redding Ridge,
Branchville, Dodgingtown, West Redding, Titicus, Hattertown, Bethel,
Danbury, New Fairfield, Newtown, Hawleyville, Botsford, Monroe,
Bridgeport, Stepney, Shelton, Huntington, Upper Stepney, Long Hill,
Trumbull, Stratford, Easton, Fairfield, Greenfield Hill, Stratfield, Nichols,
Oronoque, Rivercliff, Devon, Lordship, and East Bridgeport, New Haven,
Hartford, Torrington, Waterbury, Meriden, New Britain, New London,
Norwich, Manchester, East Hartford, Suffield, Granby, West Haven,
West Hartford, Branford, East Haven, Hamden, Woodbridge, Orange,
North Haven, Groton, Rocky Hill, Newington, Wethersfield, Glastonbury,
Bloomfield, Blue Hills, South Windsor, Naugatuck, New Hartford,
Chesire, East Lyme, Old Mystic, Wallingford, Southington, Middletown,
Bristol, Laurel Beach, Litchfield, Pleasure Beach, Mystic, North
Westchester, Double Beach, Willimantic, Storrs, Canaan, East Windsor,
Vernon, South Canaan, Putnam, Guilford, Windham, South Britain,
Willington, Windsor, East Hampton, Brooklyn, and Westchester, CT.

In addition to a Connecticut Group Disability Insurance Quote,
we can also offer your business affordable Group Health
Insurance premiums or choose another CT commercial or
group insurance coverage from the menu below.

"Your local Connecticut Group Disability insurance specialist!"

Connecticut Group Disability

Insurance Quote

Group Disability Insurance Coverage Information:

Information received from this Connecticut group disability insurance quote form sent
to Stamford Insurance Group will be for our use only and will not be sold, given to or
distributed to any other parties. A quote will be based on the group disability insurance
information provided and does not guarantee acceptance of the risk by us. The precise
coverage afforded is subject to meeting underwriting guidelines, and the terms,
conditions and exclusions of the policy as issued. By submitting this request you
acknowledge that this is neither an offer to insure nor a guarantee of insurance.
Completion of this form does not entitle you to Connecticut Group Disability
insurance. We are licensed in Connecticut, New York, New Jersey, Massachusetts,
and Rhode Island. We will not provide quotes for other states.

Connecticut Business Information:

Business Name:
Premises Address:
City:     State:     Zip Code:
Contact Name:
Phone #:    Ext #:    Years in Business:
Email Address: (Required)
Description of Operations or SIC code:

Current Insurance Company:
Policy Expiration Date:          (mm/dd/yyyy)

Do you currently offer short term disability insurance to employees?
Do you currently offer long term disability insurance to employees?
Length of Disability Coverage Needed?

Disability Coverage For?
Type of Disability Coverage Needed?
How many employees to be insured?

Monthly Benefit Amount For Each Person Insured: $
Or Enter a Different Monthly Benefit Amount:         $
Benefit Period Desired For Each Person Insured:
Elimination Period Desired For Each Person Insured:
Payment Mode:

Does any employee to be insured have a hazardous job? Yes No
If Yes, how many have hazardous jobs?

Are any employees to be insured active members of the military reserves? Yes No
If Yes, how many are active members of the military reserves?

Explain Any Recent Workers Compensation Claims Below.

Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your Connecticut Group Disability Insurance quote request.

[Short Term or Long Term]