Coverage Confidence Quiz

1

Name* This field is required.

First Name

Middle Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number

Please enter a valid phone number.

4

Do you review your insurance policy at least once a year?* This field is required.

Yes

Sometimes

No

5

Are your home and auto policies bundled together?* This field is required.(select "Yes" if you only have home or auto insurance but not both)

Yes

Not sure

No

6

How confident are you in your understanding of your liability coverage?* This field is required.

Very confident

Mostly confident

Somewhat confident

A little unsure

Not confident at all

7

Have you compared rates or reviewed your coverage this year?* This field is required.

Yes

Not sure

No

8

Do you use smart home or driver safety devices for discounts?* This field is required.

Yes

Not sure

No

9

Have you had to use your insurance in the past three years (for example, filed a claim or needed coverage assistance)?* This field is required.

Yes

Not sure

No

10

Do you know if your home policy includes water backup coverage?* This field is required.

Yes

No

11

Do you own rental, investment or vacation properties?* This field is required.

Yes, and I am appropriately covered

Yes, but I'm not sure I have proper coverage

No, I don't own additional properties yet

12

Do you currently work with an independent agent, captive agent, or not sure?* This field is required.

Independent

Captive/Exclusive

Not Sure

13

Do you feel confident your current coverage fully protects your assets?* This field is required.

Very Confident

Mostly

Somewhat

A little unsure

Not confident

14

What's your biggest insurance goal right now?* This field is required.(not scored)

Save money

Receive better service

Understand coverage

All of the above

15

What’s been most frustrating about insurance for you?* This field is required.(not scored)

16

How would you like help today?* This field is required.(not scored)

DIY guide

Full policy review/explanation

Clarify specific parts of my coverage

Advisor call

17

When does your current policy renew or when are you considering a change?* This field is required.(not scored)

This month

Next 1–3 months

3+ months out

18

Anything else we should know before we review your situation?(not scored)

19

Were you referred to Green Brook? If yes, who referred you?Please type their first and last name.

20

Coverage Confidence Score