Effective Date: [MONTH DAY, YEAR]
[AGENT FULL LEGAL NAME], Licensed Life Insurance Agent (“we,” “us,” or “our”) respects your privacy. This Privacy Policy explains how information is collected, used, stored, and protected when you submit a form, request life insurance information, schedule an appointment, communicate with us, or otherwise interact with our services.
This form is operated on behalf of [AGENT FULL LEGAL NAME], a licensed life insurance agent, for the purpose of responding to consumer requests for information regarding life insurance products and related appointments.
We may collect information that you voluntarily provide, including:
Your name.
Your telephone number.
Your email address.
Your state of residence.
Your preferred contact method or preferred contact time.
Basic information about your interest in life insurance coverage.
Appointment requests and scheduling details.
Information you provide in telephone calls, emails, text messages, forms, or other communications.
Call recordings, call transcripts, automated summaries, and communication outcome classifications, where required consent has been obtained and applicable law permits.
We may also collect limited technical information associated with use of our forms or pages, such as device information, browser information, IP address, referral information, and general page activity.
This inquiry form is not intended for the submission of Social Security numbers, payment information, bank account information, detailed medical histories, prescription histories, or complete insurance application information. Please do not submit that type of sensitive information through this form.
We may use your information to:
Respond to your request for life insurance information.
Contact you regarding your inquiry.
Schedule, confirm, reschedule, or cancel an appointment.
Provide customer service and answer questions.
Send communications related to your requested appointment or inquiry.
Follow up regarding your request for information.
Maintain customer relationship management records.
Create internal notes, follow-up tasks, communication records, or appointment records.
Improve communications, customer service, and business operations.
Comply with applicable legal, regulatory, licensing, fraud-prevention, or recordkeeping obligations.
Submitting this form does not constitute an application for insurance, guarantee coverage, bind insurance coverage, guarantee a premium, or require you to purchase any insurance product.
When you provide your telephone number and request information or an appointment, you authorize [AGENT FULL LEGAL NAME] and authorized administrative representatives acting on the agent’s behalf to contact you by telephone regarding your inquiry or requested appointment.
This authorization applies to calls relating to your request, appointment scheduling, appointment reminders, follow-up concerning your inquiry, and customer-service matters.
This permission does not authorize artificial-voice, prerecorded-voice, or automated marketing calls unless you separately provide any consent required by applicable law.
Telephone calls may be recorded or transcribed only where required consent has been obtained and where permitted by applicable law.
With required consent, call recordings or transcripts may be reviewed or analyzed using automated tools, including artificial intelligence, for purposes such as:
Identifying whether an appointment was requested or scheduled.
Determining whether follow-up is needed.
Recording whether a consumer requested additional information or declined further contact.
Producing internal summaries, notes, tasks, or communication classifications.
Supporting customer service, quality assurance, training, and business recordkeeping.
Automated tools may help organize communications and follow-up activities. They do not approve insurance applications, determine insurance eligibility, bind coverage, issue policies, or replace any responsibility of an appropriately licensed insurance professional or insurance carrier.
You are not required to participate in a recorded or transcribed telephone call. Where required by law, your consent will be requested before a call is recorded or transcribed.
If you separately consent to receive text messages, we may send text messages relating to your inquiry, requested appointment, appointment scheduling, appointment reminders, follow-up communications, and customer-service matters.
Message frequency may vary. Message and data rates may apply. You may opt out of text messages at any time by replying STOP. For assistance, reply HELP or contact us using the information listed below.
No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. Information sharing to subcontractors in support services, such as customer service, is permitted. All other use case categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.
Consent to receive text messages is not a condition of purchasing any product or service.
When you provide your email address and request information or an appointment, we may send emails relating to:
Your inquiry.
Requested information.
Appointment scheduling or reminders.
Customer-service matters.
Follow-up concerning your stated interest in life insurance products.
Where an email is promotional or marketing-related, you may opt out of future promotional emails by using the unsubscribe method provided in the email or by contacting us at [BUSINESS EMAIL ADDRESS].
Requests to stop promotional emails will be honored as required by applicable law. We may still send non-promotional communications necessary to respond to an active request, manage an appointment, or address customer-service matters.
We may use service providers that assist with operating our forms, scheduling appointments, maintaining customer relationship records, delivering communications, processing phone activity, managing consent records, maintaining data security, and providing technical support.
Such providers process information only in support of our operations, subject to applicable agreements, instructions, and legal requirements.
This form is intended only for an initial inquiry and appointment or contact request.
If you later choose to pursue an insurance application, additional information may be required through an appropriate application process. Any application, underwriting review, carrier communications, policy issuance, or coverage decision will be governed by the applicable licensed-agent and insurance-carrier processes and related privacy disclosures.
Insurance products are subject to availability, eligibility requirements, underwriting where applicable, carrier approval, policy terms, and required premiums.
We retain information for as long as reasonably necessary to:
Respond to your inquiry.
Provide requested communications or appointment support.
Maintain business, compliance, and customer-service records.
Resolve disputes.
Comply with legal, licensing, regulatory, or recordkeeping requirements.
Unless a longer period is reasonably necessary for legal, regulatory, compliance, dispute-resolution, or business-record purposes, call recordings and call transcripts may be retained for up to [SELECT ONE: 90 DAYS / 6 MONTHS / 12 MONTHS] and then deleted, de-identified, or otherwise disposed of according to our business practices.
We use reasonable administrative, technical, and organizational safeguards intended to protect personal information from unauthorized access, use, disclosure, alteration, or destruction.
However, no website, form, database, electronic communication, or storage system can be guaranteed to be completely secure.
You may contact us to:
Ask questions about this Privacy Policy.
Request correction of information you previously submitted.
Request deletion of certain information, subject to applicable legal, regulatory, compliance, and business-record requirements.
Ask to stop promotional email communications.
Opt out of text messages by replying STOP.
Tell us that you do not consent to future recorded or transcribed telephone calls.
To submit a request, contact us using the information below.
This form and our services are not directed to children under 13, and we do not knowingly collect personal information directly from children under 13 through this form.
We may update this Privacy Policy from time to time. Any updated version will be posted with a revised Effective Date.
Questions about this Privacy Policy or our information practices may be directed to:
[AGENT FULL LEGAL NAME], Licensed Life Insurance Agent
License Number or NPN: [LICENSE NUMBER OR NPN]
Email: [BUSINESS EMAIL ADDRESS]
Phone: [BUSINESS PHONE NUMBER]
Mailing Address: [BUSINESS MAILING ADDRESS]