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Home > Health > Disability Insurance Quote
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Disability Insurance Quote


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information
First Name *
Last Name *
Street *
City *
State *
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Primary Phone Number *
Alternate Phone Number
E-Mail Address *
Additional Information
Date of Birth *
/ /
Gender *
Height *
Weight *
Tobacco Used? *
Occupation
Coverage Options
Do you currently have insurance?
Cost of Previous Coverage Per Month
Coverage type desired
Would you like to add to existing coverage?
What is your net annual income?
Desired Coverage Per Month
When will this change take effect?
/ /
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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About Us

We are a niche, independent, market insurance agency dedicated to providing the highest level of protection and service. Through on-going servicing and training of targeted industries, we commit ourselves daily to the idea that it is far better to not just service our client's industry but to specialize in it.
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"Scott is a fantastic insurance agent! He works hard with customers to not only be competitively priced but to make sure you have the best coverage!"- Angela Anderson

"Thank you SO much, Boulder Ridge Insurance, for going above and beyond to help our company with our bond issue. The service you provide is second to none. We appreciate you dropping everything and meeting us personally to get papers notarized and in our  hands within a matter of hours." - Electrical Lighting Solutions
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P.O. Box 59

Albertville, MN 55301


           

                       


PH: 763.200.9410
FAX: 763.208.7508


                        

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