Refer a Life Insurance – Nour Assurance

Client & Coverage Information

All fields are required to process your referral

Submitting Broker

Your Name

Client Personal Details

First Name

Last Name

Home Address

Phone Number

Email Address

Date of Birth

Smoker Status

Product Interest

Select all products the client is interested in — multiple selections allowed.

Term Life Fixed coverage for 10, 20, or 30 years

Whole Life Lifetime coverage with cash value growth

Universal Life Flexible premiums with investment component

Critical Illness Lump sum payment on serious diagnosis

Disability Insurance Income replacement if unable to work

Health & Dental Extended health and dental coverage

Select Term Duration:

10 Years 20 Years 30 Years Not Sure Yet

Our life insurance specialist will contact the client within 24–48 business hours.

Referral Submitted!

Thank you for the referral. Our life insurance specialist will reach out to the client within 24–48 business hours. Your referral fee will be issued once the policy is active.

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Your Referral Fee

Paid once the policy is active

1 Month Premium

Referral Fee

Equivalent to the client's first monthly payment

What Happens Next

Within 24–48 hrs Our specialist contacts your client to discuss their needs.

Quote & Application We prepare a tailored quote and guide the client through the application.

Policy Issued Once active, your referral fee — equal to 1 month's premium — is paid to you.