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Smithwick and Mariners Insurance

A Division of Brown & Brown

Call 1-207-781-5553
for a free rate quote

Insurance for Auto, Home, Life, Business, Yacht and Commercial Marine

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Life Insurance Application

Name * Required
First Last
Business Name
Address * Required
Street Address Address Line 2 City State ZIP Code
Phone * Required
Fax
Email * Required
Occupation(s)
Date of Birth (MM/DD/YYYY)
MM slash DD slash YYYY
Sex
- Male
- Female
Ammount of Coverage Needed
Term Needed
- 5 yrs
- 10 yrs
- 15 yrs
- 20 yrs
- 25 yrs
- 30 yrs
Permanent
- Universal
- Whole Life
Have you used any form of tobacco in the past year?
- Yes
- No
Have you used any form of tobacco in the past three year?
- Yes
- No
Please list any health or height/weight concerns so we can provide an accurate estimate

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Smithwick & Mariners Insurance
A Division of Brown & Brown
366 US Route 1, Falmouth, Maine 04105
*Please note, coverage cannot be bound nor changed using this system.

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Commercial & Marine Insurance Throughout New England - Auto, Home & Life Insurance in Maine.

© 2025 Smithwick and Mariners Insurance

Brown & Brown acquired Smithwick and Mariners

Beginning June 1 this website will be automatically redirected to the new Brown & Brown Retail segment website.

While our website address is changing, the excellent service our customers receive will remain unchanged. Unifying our website under the Brown & Brown brand name allows us to better serve you by simplifying and streamlining our resources across the retail segment of our organization.

Visit and bookmark the Brown & Brown website, BBrown.com, now and see how we are better together!