• Information Needed to Quote Your Insurance

  • How long have you been at your current address?*
  • What is the closing date or move date?
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    2 digit month, 2 digit day, 4 digit year
  • My current living situation is:*

  • Are you OK with paperless delivery of policy documents (most companies offer an extra discount for this)?*
  • Named Insureds (owners of the policy or policies). If you're married, we have to list your spouse.*
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  • Do you plan on any changes occurring in the next year?*
  • What policies are you wanting quotes for?*

  • We tend to work on quotes in the order they come in. Do you have an urgent matter that would require us to work on this sooner?
  • What date do you need this by?
     - -
    2 digit month, 2 digit day, 4 digit year
    • Auto Insurance 
    • Drivers (include everyone that lives with you that currently or has had a license, or regularly uses any of your vehicles):*
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    • Do any drivers have any tickets, accidents, or claims filed in the last 5 yrs?*
    • Please provide more information for all tickets/accidents/claims in the last 5 yrs.*
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    • Are you willing to do a telematics (tracking) program to earn discounts for safe driving habits?*
    • Vehicles*
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    • Vehicles continued*
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    • Vehicle Coverages*
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    • Do you have a travel trailer you want to insure?*
    • Please provide the following for each travel trailer:
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    • Travel Trailer info continued
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    • Travel Trailer use and coverage
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    • Trailer Coverages continued
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    • Are you willing to look at a higher deductible to get a lower rate?*
    • Are there any other coverages you want that aren't listed above?*
    • Do any of these vehicles have a hitch?*
    • Want any optional coverages:

    • Want any of these optional coverages:*
    • How do you prefer to pay your auto insurance*

    • Do you currently have auto insurance or are you listed as a driver on an insurance policy?*
    • Do you want us to use the renewal date for your quote?*
    • What date should we use? For the best possible rates, we suggest at least 2 weeks from today.*
       - -
      2 digit month, 2 digit day, 4 digit year
    • Current Liability Limits*
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    • Liability Limits you want quoted*
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    • Homeowners Insurance 
    • Do you have a basement?*
    • Do you have a:
    • Do you have a:*
    • Do you have a dog?*
    • Dogs*
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    • Is your yard fenced in?*
    • Do you have a sump pump?*
    • If you have any structures not attached to your home, are there any heating devices in those structures?*
    • Year of Updates: (if unsure, put in your most reasonable guess, if still original to the house, put in the year the house was built)*
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    • Are there any current issues with any building on your property, or issues on the property? This is extremely important, so please go through each one.*
    • Are you willing to fix all of the issues above immediately or ASAP?*
    • Are you currently insured for this home?*
    • Current Coverage Amounts: (would show on your current declaration) *
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    • Do you want any of the following optional coverages your current company may not offer?*
    • Are you willing to look at a higher deductible for a lower rate?*
    • Who pay will be paying the home premium now and in the future?*

    • As far as you know, have there been any claims in the last 5 yrs on the home or on your home/renters policies?*
    • Please provide more information for all claims in the last 5 yrs.*
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    • Do you have any scheduled items on your current policy?*
    • Renters 
    • Is there a sprinkler system?*
    • Do you personally have any
    • Do you personally have any:*
    • Life Insurance 
    • Who all are you wanting to cover?*
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    • Health Insurance 
    • Who are you wanting coverage for?*
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    • Let's see if you qualify for a new plan right now. Have any of these happened in the last 60 days?*

    • Umbrella 

    • Umbrella policies provide more liability coverage should you run out of coverage on your underlying policies. For example, you have a car accident where you are at fault and you're covered. Their medical bills, physical rehab bills, prescriptions, missed time from work, etc all add up to $850,000. You auto policy pays up to the policy limit, let say $250,000. With an umbrella, that policy would cover the other $600,000. Without an umbrella, they would come after you for reimbursement. It can vary by State what they are able to come after, but usually they can garnish your wages, take any money you have in savings, take tax returns, and can force you to sell extras (extra car, boat, motorcycle, ATV, 2nd home, etc.). For this reason, we recommend you at least have more coverage than you have in total assets, while also factoring in your income level to protect that too.

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