Welcome to the American Alpine Club Life Insurance Program!  We stand ready to assist AAC members in their search for affordable "climbing friendly" life insurance plans.  

Instead of taking a "one size fits all" approach, we work closely with our various insurance company partners to create a custom policy that suits your needs.  In order to do so, we need to get to know you and learn more about your current health and climbing activities.  Therefore, we ask that you complete the form below. 

Thank you for this opportunity to be of service!

Name *
Name
Phone *
Phone
Address *
Address
Gender *
Current Health Status *
Tobacco Use
Are you a current AAC member? *
Desired length of coverage? *
Type(s) of climbing? *
click all that apply
Any climbs in the past 24 months above 13,000 feet (4,000 meters)? If yes, provide details including total number of climbs, heights attained and safety equipment used. Please also include the country/region and the name of the peak(s) and route(s) and, if applicable, include the YDS grade/numerical difficulty rating (should correspond with your answers above) *
Please check any additional activities you have done in the past 24 months or intend to do in the next 24 months *
please check all that apply
Interested in other products?
Please click all that apply

* Not all of these plans are available in every state. Please ask the plan administrator about plan availability in your area. The Life Insurance and other benefit services are provided as a “service” performed by licensed agents with the Nicholas Hill Benefit Group, Inc. (NHBG). Plans are subject to full underwriting and may potentially exclude or decline to offer coverage based on pre-existing health conditions, occupations, avocations (including climbing/mountaineering), etc. NHBG is committed to assist in locating and selecting the most beneficial insurance policy for AAC members. NHBG works with dedicated teams of underwriters with various insurance companies and are experienced in securing coverage for clients engaged in sports and activities that are often considered “higher risk,” such as climbing/mountaineering.