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Policy Check-up
Is your coverage keeping pace with your life changes? Completing a quick check-up helps us ensure you're properly insured and protected.
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Please enter your name and contact information to begin the review process.
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3
Do you have Auto Insurance with our agency?
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This field is required.
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4
Would you be interested in receiving a complimentary quote?
You could potentially save 20% or more on your home with a companion discount.
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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?
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7
Name of the Driver:
First Name
Last Name
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Date of Birth:
Date
Drivers License Number:
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8
Have you paid off any of your vehicles in the last year?
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9
Please list the vehicle or vehicles that you paid off:
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10
Do any of the vehicles on your policy have custom equipment (after market stereo, audio/visual equipment, or other accessories)?
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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
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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.
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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.
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15
Name of the Driver qualifying for the Good Student Discount:
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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?
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18
Please list the vehicle and garaging address so that we can update your policy accordingly.
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Do you or any drivers in your household use your personal autos to drive for companies like Uber, Lyft or DoorDash?
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20
Do you have a homeowners, condo, or renters insurance policy with our agency?
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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
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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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Max. file size
: 10.6MB
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23
What type of property policy do you have?
Homeowner's Policy
Condo Owner's Policy
Renter's Policy
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24
Which type of policy do you have?
Homeowner's Insurance
Renter's Insurance
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25
Have you refinanced your home or paid off your mortgage in the last year?
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26
Please give us more details. If you refinanced your new mortgage company and loan number would be very helpful.
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When was the last time you had your roof replaced?
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28
Have you updated or remodeled your home in the last 12 months? Or have you added any outbuildings or other structures?
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29
Please describe the updates made to your property and let us know if you would like to increase your dwelling coverage.
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30
Have you updated or remodeled your home in the last 12 months?
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31
Please describe the updates made to your property and let us know if you would like to increase your coverage.
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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.
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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?
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34
Please describe the items purchased and the value of the items purchased.
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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?
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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
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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
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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?
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40
Please tells us about your specialty vehicles. Type, Year, Make, Model and Value
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41
If you have current insurance, please provide us with a declarations page.
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42
Is there anything NOT mentioned that has changed that you think may affect your insurance policies?
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