Personal Insurance Annual Review

1

Please enter your name and contact information to begin the review process.

Please enter your name

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2

We use your cell phone number as our primary way of reaching you. I consent to receive SMS from Hanby Insurance. Reply STOP to opt-out; Reply HELP; Message and data rates apply; Messaging frequency may vary. Visit our website to view the Terms and Conditions and our Privacy Policy.

Yes

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3

Do you have Auto Insurance with our agency?* This field is required.

YESNO

4

Would you be interested in receiving a complimentary quote?You could potentially save 20% or more on your home with a companion discount.

YESNO

5

Please upload a copy of your current auto insurance declarations, if available. This will help us provide the most accurate quote.We strive to provide a quote within 48 hours of receiving all necessary information. If you require a quicker turnaround, please don't hesitate to contact our office directly.

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6

Are there any new drivers in your household?

YESNO

7

Name of the Driver:   First Name     Last Name    .
Date of Birth:    Date
Drivers License Number:

8

Have you paid off any of your vehicles in the last year?

YESNO

9

Please list the vehicle or vehicles that you paid off:

10

Do any of the vehicles on your policy have custom equipment (after market stereo, audio/visual equipment, or other accessories)?

YESNO

11

Please describe the custom equipment, the value of the equipment, and the vehicle it was installed on. Example: Customer Stereo valued at $1,000, installed on the 2021 Toyota Tacoma

12

Do you have any receipts or photos of the equipment for our file?

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13

If your carrier offers it, would you be interested in learning more about telematics discount programs?This is driver monitoring via cell phone app or a plug in device installed on your car. Telematics can save you up to 30% with some carriers.

YESNO

14

Do any of the drivers in your household qualify for a Good Student Discount?Must be a B (3.0) or better to qualify.

YESNO

15

Name of the Driver qualifying for the Good Student Discount:

16

Do you have a copy of the grades or a screenshot of the transcript for our records?

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17

Are any of the vehicles in your household garaged at address other than your primary home address?

YESNO

18

Please list the vehicle and garaging address so that we can update your policy accordingly.

19

Do you or any drivers in your household use your personal autos to drive for companies like Uber, Lyft or DoorDash?

YESNO

20

Do you have a homeowners, condo, or renters insurance policy with our agency?

YESNO

21

Would you be interested in getting a quote?You could potentially save 20% or more on your home or renters policy with a companion discount

YESNO

22

Please upload a copy of your current insurance declarations, if available. This will help us provide the most accurate quote.We strive to provide a quote within 48 hours of receiving all necessary information. If you require a quicker turnaround, please don't hesitate to contact our office directly.

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Select files to upload

Max. file size: 10.6MB

23

What type of property policy do you have?

Homeowner's Policy

Condo Owner's Policy

Renter's Policy

24

Which type of policy do you have?

Homeowner's InsuranceRenter's Insurance

25

Have you refinanced your home or paid off your mortgage in the last year?

YESNO

26

Please give us more details. If you refinanced your new mortgage company and loan number would be very helpful.

27

When was the last time you had your roof replaced?

28

Have you updated or remodeled your home in the last 12 months? Or have you added any outbuildings or other structures?

YESNO

29

Please describe the updates made to your property and let us know if you would like to increase your dwelling coverage.

30

Have you updated or remodeled your home in the last 12 months?

YESNO

31

Please describe the updates made to your property and let us know if you would like to increase your coverage.

32

Hanby Insurance recommends carrying loss assessment coverage of at least $10,000.

I already carry $10,000 or more in loss assessment coverage

I am not interested in increasing my coverage at this time.

33

Have you purchased or acquired any of the following in the last 12 months: Jewelry, firearms, cameras, fine art, musical instruments, furs or silver?

YESNO

34

Please describe the items purchased and the value of the items purchased.

35

If you have any receipts or appraisals please provide a copy as they may be required by underwriting.

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36

Flooding is not covered under your insurance policy. Would you be interested in receiving a quote for flood insurance?

YESNO

37

Personal Umbrella Policy: This policy provides extra liability coverage over both your home and auto policies. Coverage amounts range from $1M-$5M depending on your need. We recommend these policies to anyone with a pool, teenage drivers, or assets to protect. The average cost of an umbrella policy is about $250/year.

I already have an umbrella policy with Hanby

Please contact me to discuss

I'm not interested in this coverage right now

38

Life Insurance: Did you know our office also writes term life insurance? No one ever expects the unexpected. However, should your family experience a tragedy, life insurance will help them keep their current lifestyle and provide for them when you can't. The gift of life insurance is the most important gift you can give your family after you're gone.

Please contact me to discuss

I'm not interested in this coverage right now

39

Do you have any motorcycles, boats, RV's, golf carts, ATVs or classic cars that you would like for our agency to quote for you?

YESNO

40

Please tells us about your specialty vehicles. Type, Year, Make, Model and Value

41

If you have current insurance, please provide us with a declarations page.

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Max. file size: 10.6MB

42

Is there anything NOT mentioned that has changed that you think may affect your insurance policies?