ShelterPoint Life Insurance – Formerly First Rehab Life 1972 Located at
1225 Franklin Avenue, Ste. 475, Garden City, NY.
Phone: 516-82908100

Online Registration [For Appointed Producers]

Please enter the following information to open an online account.

Fields marked with * are mandatory.

Are you an Officer or Owner of
this Agency ?
*Please enter your Producer#


*Your Agency Name
(*Enter your name if not applicable)

 

Please choose a password


Password must be: 8-12 characters in length, contain an upper case letter, contain a lower case letter, contain a number and contain a special character ($@!%*?&#^).

*Your E-mail

*Password

*Re-enter Password

Please select a hint question from the below dropdown, and provide an answer for it . This will help us to verify your identity in the future if you forget your password.

*Hint Question

 
*Answer

 

Contact Information


*First Name

 
*Last Name

 
*Address

 
*ZIP

 
*City

 
*State

 
*Telephone

Fax


*Type of Business

*Tax ID(#########)
[Exclude dashes]

*Social Security # (#########)
[Exclude dashes]

 

License Information


*License Number (e.g. LA-123456)
Please enter your full license number in the following formats:
  • BR-XXXXXX
  • LA-XXXXXX
  • LB-XXXXXX
  • PC-XXXXXX

 
*License Issued State

 
*License Effective Date

*License Expiry Date

Attach a copy of the license

 

Terms & Conditions

I am submitting this online producer account application to establish an administrative account with ShelterPoint Life Insurance Company and all of its subsidiaries (collectively referred to as "ShelterPoint"). The information submitted is accurate and true to the best of my knowledge, and I am creating this administrative account for my use in:

  1. Submitting DBL applications and updating account information.
  2. Downloading and viewing applications, statements, forms and license information.
  3. Checking the status of commission payments and premium payments made by me, my agency or the insured.

Licensed agents or brokers in my employ may have access to this account only after I have provided ShelterPoint with the name and license number of the licensed agent or broker in my employ, or affiliated with my agency or brokerage, who will have such access. Once I have provided ShelterPoint with each user’s information I must establish a separate account for each agent’s or broker’s use.

I acknowledge that I must maintain this account by adding or deleting users and must ensure the validity of the users on my account. If a designated user leaves my employ or ceases affiliation with me, I must delete that account and notify ShelterPoint of the inactive status. Failure on my part to maintain this account and ensure the validity of users may result in termination of this online account and other actions by ShelterPoint.

ShelterPoint retains the right, in its discretion to cancel any account or user access for misuse of this site or any downloaded applications and forms. As the primary user on this account, I am responsible for each user’s access and activity, and will be liable for any costs or other penalties associated with their use of this account.

I understand that my use of this website and the services available through this website are optional, and by clicking “Accept”, I agree to comply with the Terms of Use and the conditions set forth above.

*Enter the letters as they are shown in the image above.
(Letters are not case-sensitive)