1. Three Steps to Closing the Sale!
For Allianz Life Only
FOR AGENT USE ONLY

2. Step 1 Medical Underwriting for an Informal Offer
Kai-Zen works best if client is rated Standard or Better with the carrier. Doing an informal medical review let’s you know up front and avoids client paying for a trust they cannot use if they don’t move forward with the plan.

3. Allianz Income and Net Worth Requirements for Kai-Zen Cases…
Income of $400K
Or Income of $200K-$399K AND Net Worth of at least $500K
Or Income of $100K- $199K AND Net Worth of at least $1MM
Medically rated as standard or better
Age
*Please make sure your client fits the profile(s) above before submitting a case.
Allianz will not reimburse your costs for ordering medical exam/APS’s unless
case closes.

4. TO SUBMIT CASE TO ALLIANZ
INFORMAL FORMS NEEDED
TO SUBMIT CASE TO ALLIANZ
DOWNLOAD. The forms below from
Cover Letter for Allianz Informal
Informal Sheet for Allianz Life
DOWNLOAD. The forms below from
Hipaa Form (NB3046-WS)
*If the agent is not licensed with Allianz to write business in the state of Nevada they
may submit the informal application, but MUST get licensed in Nevada PRIOR to
submitting the formal application because the trust owning the policy is domiciled in Nevada.

5. Allianz Cover Letter Insured/client first and last name
Agent first and last name
Allianz Income and Net Worth REQUIREMENTS
for Kai-Zen
FORMAL Application will be NEVADA for all
Kai-Zen cases as Trust is in Nevada
IMPORTANT – IF AN EXAM OR MEDICAL RECORDS ARE
NOT SENT IN WITH THIS INFORMAL COVER LETTER OR
AT LEAST AN EXPECTED DATE OF EXAM AND NAME OF EXAM
COMPANY – ALLIANZ WILL NOT REVIEW THE CASE.
Note* if the client is between years of age and is applying
for more than 3Million in death benefit APS’s will be required

6. Allianz Informal Application/Sheet
Please complete ALL blanks.
Face Amount – has to minimum of $1.5M for
Kai-Zen cases – can be more
What are considered “Liquid Assets”
Cash
Property immediately convertible to cash:
Securities
Notes
Life insurance policies with cash surrender values
U.S. savings bonds
Account receivables
Once this list has been complied for the prospective client total up the “liquid assets” and write the number, in the space provided.
Please be sure and forward to and NOT to Allianz directly – they will not process unless it comes through Kai-Zen Plan/NIW first.

7. HIPAA John Smith 04/15/1976 Print First and Last Name Date of Birth
Sign
Date signed
Proposed Insured Signature
Date Signed
Self

8. Submit Informal to get Medical Offer
The Cover Letter, Informal Cover Sheet and HIPAA should be
submitted directly to for review.
Kai-Zen Plan/NIW will review to make sure complete and client
qualifies per Allianz requirements – then we will submit to Allianz.
Please make sure lab slip/copy of exam and/or barcode are included
– Allianz will not review an informal without the full exam/labs
OR Medical Records.

9. Congratulations Step 1 of the Enrollment Process is done
Once you receive your informal medical offer, start Step 2 of the Enrollment process