Why are insurance coverage reviews important?  The insurance industry is always changing as are the exposures you are faced with each day.  By reviewing your coverage prior to each renewal, we can better protect you from having an unexpected loss that is not covered by your insurance policy. 

Please take a minute to complete the information below concerning you and your vehicle(s).  When finished, click the "Submit" button.

Client Information
First Name:
Last Name:
Policy Number:
Email Address:

Renewal Review
Are the names, addresses and insured locations correct on all correspondence? Yes   No   N/A
Is the driver and vehicle information correct on the policy? Yes   No   N/A
Do we insure all your vehicles? Yes   No   N/A
If your vehicle is customized, have you notified us? Yes   No   N/A
Are all licensed drivers who are residents of the household listed on your policy? Yes   No   N/A
Do you have current proof of insurance cards in each of your vehicles? Yes   No   N/A
Are your liability limits adequate to protect your assets and future earnings? Yes   No   N/A
Does your uninsured/underinsured motorist limits match your other liability limits? Yes   No   N/A
Do you have a personal umbrella policy? Yes   No   N/A
If you have a personal umbrella policy, does your liability limit meet your underlying requirements? Yes   No   N/A
Do you have towing coverage? Yes   No   N/A
Do you have rental reimbursement coverage? Yes   No   N/A
Do you consider any of your vehicles to be antique or vintage? Yes   No   N/A
If you have a cell phone, CB, stereo or other equipment not built into your car or  factory installed, has special coverage been added to your policy? Yes   No   N/A
If you have a loan or lease on your car, is the lender properly shown on the policy? Yes   No   N/A
Would you like to increase your deductible to reduce your premium? Yes   No   N/A
Are there any student drivers who maintain a "B" average or better? Yes   No   N/A
Are there any drivers who have completed a certified defensive driving course? Yes   No   N/A
Are any vehicles used in connection with a business? Yes   No   N/A
If you are regularly furnished with a company vehicle, have you notified us? Yes   No   N/A
Is the named insured or spouse the titled owner(s) of all vehicles listed on your policy? Yes   No   N/A
If you had a claim in the past year, was it handled to your satisfaction? Yes   No   N/A
Additional Comments:
FAILURE TO RECOGNIZE OR CORRECT THESE MATTERS COULD NEGATIVELY IMPACT A RECOVERY IN A CLAIM SITUATION.   IF CHANGES ARE NEEDED OR IF YOU HAVE QUESTIONS, PLEASE CALL US IMMEDIATELY.

Due to technical issues beyond our control, we cannot guarantee receipt of this questionnaire.  If there are any immediate changes that need to be made to your policy, please contact us directly.    

 

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