Group Disability Insurance Quote NH

Gorman Insurance and Risk
Management Services of
Somersworth, NH offers
affordable Commercial
Insurance coverage options
and experienced business
insurance services
throughout New
Hampshire, southern
Maine, and Massachusetts.

Contact us about Group
Health Insurance toll free at
1-800-678-3431, as well as
Group Life and Group
Long Term Care Insurance
services for your NH, ME,
or MA business.

In addition to New
Hampshire Group
Disability Insurance, we
also offer affordable
Group Life Insurance
plan services.

We are your local southeastern New Hampshire, southern Maine
insurance agency, offering experienced group disability insurance services
to businesses located in the following cities and counties: Somersworth,
Durham, Portsmouth, Dover, Rochester, Rollinsford, Barrington, Madbury,
Lee, Strafford, Farmington, Milton, Barnstead, Nottingham, Northwood,
Raymond, Newmarket, Newfields, Stratham, Rye, Hampton, Epping,
Exeter, Salem, Danville, Deerfield, West Rye, Derry, Chichester, South
Barnstead, Gilmanton, New Durham, Wolfeboro, Alton, Laconia, Berlin,
Lebanon, East Candia, North Hampton, Hanover, Littleton, Plymouth,
Claremont, Newport, Keene, Hampton, Rye Beach, Strafford County,
Rockingham County, Hillsborough County, Merrimack County, and
Belknap County, NH. We also offer group disability insurance services
throughout the state of New Hampshire, including the Manchester,
Nashua, and Concord area. Our service area in southern Maine includes
the following cities and counties: South Lebanon, Kittery, Eliot, Berwick,
Sanford, Blaisdell Corners, Springvale, Emery Mills, Wells Beach, York
Beach, Kittery Point, Kennebunk, Saco, Biddeford, Alfred, Portland,
Scarborough, Westbrook, Waterboro, Shapleigh, Newfield, Buxton,
Goodwins Mills, South Sanford, Cape Elizabeth, South Portland, York
County, and Cumberland County, ME.

New Hampshire Business Information:

Business Name:
Premises Address:
City:
State: (New Hampshire, Maine or Massachusetts)
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)

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

Group Disability Coverage For?
Type of Group 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?

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 prior NH, ME, MA workers comp or serious health issues below.

Additional Question or Comment:

Click on the "Submit Quote Information" button below to send
your New Hampshire Group Disability insurance quote request.**

**Information received from this New Hampshire Group Disability Insurance quote request form sent to Gorman Insurance and Risk Management Services, 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 policy 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 your business to a New Hampshire Group Disability Insurance Policy. We are licensed in New Hampshire, Maine, Massachusetts, and will not provide quotes for other states.