1. Customer
  2. Plans Plans
  3. Enrollment
  4. Confirmation
Donald Kirkendall (ID: 241230)

Important Information (Updated: 3/28/2018)
NEW Product Guide - Your sales planning tool with useful information to help you help your clients before, during and after the sale.

Products underwritten by Time Insurance Company and National Health Insurance Company (including Short Term Medical) can be sold through this one consolidated platform!
Please email NatGenAHAgentServ@ngic.com with a subject line of “New Appointment Request” to access all the products National General Accident & Health has to offer.
To expedite your appointment request, please include your 6-digit Agent ID in the body of your message.

Quote any of our Short Term Medical or Supplemental plans here!


Zip Code is required.

Invalid U.S. zip code.

No products are available in this state.

Per our license and/or appointment information, you are not currently authorized to sell in this state.

Please contact your sales representative at 888.376.3300 for any questions regarding this message.

Effective date is required.

Effective date must be tomorrow or later.

Effective date cannot be more than {{effectiveDateRange.QuotingDays}} days in the future.

Effective date cannot be on the 29th, 30th or 31st.

Invalid effective date.

List Bill number is required.

To set up a List Bill go to www.ngah-ngic.com to download and complete a List Bill Account Agreement.


Primary's gender is required.

Primary's date of birth is required.

Date of birth cannot be in the future.

Invalid birthdate.


Primary's smoker status is required.


Spouse's date of birth is required.

Date of birth cannot be in the future.

Invalid birthdate.


Spouse's smoker status is required.


Dependent's gender is required

Dependent's date of birth is required.

Date of birth cannot be in the future.

Invalid birthdate.

Remove Dependent Remove Dependent


Answer "Yes" if you have used a tobacco/nicotine product within the last six months (religious or ceremonial uses do not apply)

We're Moving!

In an effort to bring you more of the CRM capabilities you have been asking for, we are transitioning to a new National General quote and enrollment platform to help you better support your customer needs.

The new platform will allow you to:

  • Email Quote Proposals
  • Save Quotes and Shopping Carts
  • Enroll via a Consolidated Application Experience
  • Build and Save your favorite package(s) of plans for quote and enrollment
  • Utilize Consumer facing agent sales links
  • Monitor customer actions via email tracking features
  • Manage your own Cross-Selling product options

To try the new platform today, please click the button below to create your account credentials and jump right into the next generation of the National General Experience!


To continue on with use of the traditional QuoteNatGen website today, please click the button below.