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LIFE INSURANCE NEEDS ANALYSIS WORKSHEET

To help you identify your Life Insurance needs and to ensure that you ask for or shop for the proper fit, begin your assessment with this Life Insurance Needs Analysis Worksheet:

Step 1: Calculate how much income your survivors will need each month.

Food:	$
Clothing:	$
Housing:
Rent (mortgages discussed below)	$
Property taxes	$
Utilities	$
Insurance premiums	$
Home maintenance and repair	$
Transportation:
Public transit	$
Car lease	$
Car insurance, licence	$
Car maintenance	$
Education:	$
Child care:	$
Investments:
Life insurance premiums	$
RRSP contributions	$
RESP contributions	$
Other investments	$
Vacations and entertainment:	$
Other:	$
TOTAL	$                                                    (A)

Step 2: To find out your survivors' annual income needs, multiply the monthly needs (A) by 12: $ (B)

Step 3: To determine the annual shortfall, calculate your survivors' current annual sources of income, plus any government benefits.

Salary (annual)	$
Canada/Quebec Pension Plan benefits	$
Survivor benefits	$
Orphan benefits	$
Interest and investment income	$
Unemployment insurance	$
Other sources of income	$
TOTAL	$                                                            (D)

Subtract (D) from (B):

(B) $ — (D) $ = (E) $

This is the annual shortfall. If (E) is a negative number, calculate it as zero (0).

Step 4: Calculate immediate lump-sum expenses and debts.

Final expenses (funeral, burial)
Mortgage(s) (unless there is mortgage insurance)
Loans (car, student, business, personal)
Legal/probate fees
Business expenses
Medical bills
Income taxes
Credit card debt
Other debt
TOTAL	(F)

Step 5: Calculate any future lump-sum expenses, like a new car or children's university education. Also, calculate an amount to account for inflation, if necessary.

Car
Education tuition fees
Other future expenses
Inflation
TOTAL	(G)

Step 6: Calculate the amount of life insurance coverage you will need.

6A. Divide annual shortfall (E) by 6% (or 0.06; conservative), 8% (or 0.08; less conservative), or 10% (or 0.1; optimistic) to calculate future capital needs. (If annual shortfall is zero, go to step 6B.)

(E) $ X [0.06 or 0.08 or 0.1] = $ (H).

6B. Add:

Future capital needs (H):	$
Immediate lump-sum expenses/debts (G):	+ $
Future lump-sum expenses (F):	+ $
TOTAL:	= $
Subtract any life insurance coverage you may already have through group and other insurance plans	- $
TOTAL:	= $

This is the approximate amount of life insurance coverage you need today. Remember, an individual calculation should be done for each spouse/partner in a relationship. This needs analysis does not take into account inflation, which will magnify your life insurance needs over time. For a detailed analysis of your insurance needs, call or email Daniel La Tour, Insurance Advisor & Broker for JustinCase. JustinCaseInsurance.com  Toll-Free at 1-888-977-7778 or email: daniel.latour@justincaseinsurance.com

Your Name:
Province:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
Male-Female?: Male Female	Smoker or Non-Smoker? Yes No
Pre-existing Medical Conditions:
Amount of Life Insurance in force:
Amount of Group Insurance in force:

For the lowest premium and best value buy Life Insurance Quote, send your Needs Analysis Worksheet by fax Toll-Free to 1-888-245-5505 or by mail to 147 Place Terry Fox, Kirkland, Quebec H9H 4Z5.

Insurance Needs Analysis Worksheet (reprinted with permission from The Facts of Life by Paul Grimes [with Susan Goldberg])