INSURANCE POLICY REVIEW:
Looking To Save On Auto Insurance (Click Here >>>)
Does the Policy Includes Primary and Secondary Person (ex. Husband/Wife, or Child/Parent)
*
Yes
No
Do you have any additional Drivers such as children, room mates, family members besides your spouse added to your insurance
*
Yes
No
What coverages do you have
*
Bodily Injury
Property Damage
Uninsured/Underinsured Motorist Bodily Injury
Uninsured/Underinsured Motorist Property Damage
Personal Injury Protection
Medical
Comprehensive
Collision
Rental
Roadside
Loan/Lease Payoff
What limits do you have for Bodily Injury to others?
*
No bodily Injury Limits
$10,000
$25,000
$30,000
$50,000
$100,000
$250,000
$300,000 Combine Single Limits
What limits do you have for Property Damage to others
*
No Coverage
$10,000
$15,000
$25,000
$30,000
$50,000
$100,000
$250,000
$300,000 Combined Single Limits
Do you finance your car?
*
Yes
No
Do you Uber, Lyft or Door Dash any customers for a Fee?
*
Yes
No
Have you taken any Defensive Driving Courses in the last 3 years?
*
Yes
No
Have you had any accidents, claims or damages more than 7 years?
*
Yes
No
Have you had any tickets, or violation more than 5 years ago. If yes?
*
Yes
No
How many cars need insurance?
*
1 Car
More than one Car
Are their any teen drivers that have good grades at least a B average or above
*
Yes
No
Check the one that applies
*
Teen Driver has a License
Teen Driver has a Permit
How long have you been with your current auto insurance?
*
Less than 6 months
6 months to 1 year
1 year and up
Do you Drive Less Miles than you requested
*
Yes
No
Do you like to have access to review document through email?
*
Yes
No
Do you like signing documents online?
*
Yes
No
Do you like having making your own payments online using your phone or computer?
*
Yes
No
Do you need insurance to protect your property or your things or do you have any motorcycle, Boats, ATV's, Golf Cart, Travel Trailer?
*
Yes
No
Email
*
example@example.com
Terms and Conditions: This document is used only to give you ideas of how to save money on car insurance based on the information you provided. This is no way intended to sell or distribute any car insurance. Due to the nature of car insurance this document can only be used for your personal use. Please do not give
*
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