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Pre-Renewal Risk Assessment (Click Here)


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information
First Name
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Last Name
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Street
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City
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State / Province
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ZIP / Postal Code
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Primary Phone Number
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E-Mail Address
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Home Owners / Condominium / Renters
Are you planning or have you recently completed a renovation/addition which may include; updating your roof, installing a pool, finishing a basement or any other major home improvements?
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Please verify existing and/or recently installed protective devices or systems?
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Do you own or lease additional residential location(s) which you occupy or rent?
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Do you have any additional "Structure(s)" on your property which you rent to others?
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Do you have any contents in a storage or off-site facility?
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Are you conducting a business you own out of your home?
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Do you have a finished basement?
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If you currently do not have Flood Insurance, would you like a quotation for flood? In most instances, Flood Coverage is excluded from your homeowner policy.
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Would you like to obtain a quotation for additional MOLD remediation coverage since your current policy may have limited coverage?
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Would you like to obtain a quotation for Earthquake coverage?
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Have you purchased additional jewelry, furs, fine arts and/or silver, which are not specifically scheduled on your current policy?
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Have you recently paid off a mortgage?
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Do you own/lease a horse or maintain any livestock on your property?
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Automobile
Are there any newly licensed drivers in your household?
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Do you own a recreational vehicle (Watercraft, ATV, Motorcycle, Snowmobile, Golf Cart, Motor home, Moped, Motor scooter or all-terrain vehicle)?
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Are any of your personal automobiles used for livery or business purposes?
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If you do not currently own a vehicle, would you be interested in a quote for a "Non-Owned Auto" policy?
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Personal Liability/Excess Liability
Would you like to add/increase personal excess liability coverage? We strongly recommend a minimum of $5,000.00 excess liability coverage limit over and above other personal liability policies.
Required
Do you employ a full or part-time domestic employee? (Workers compensation is required by law, for individuals employed more than twenty (20) hours per week whether or not they have working papers.)
Required
Would you like to purchase Employer Practice Liability Coverage, which protects your from a domestic employee's allegations or Sexual Harassment, Wrongful Termination or Discrimination Laws?
Required
Are you presently a board member of a charitable organization / not-for-profit and desire Director and Officer's Coverage?
Required
Is your home used as a venue to host charitable events?
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Are any of your properties, vehicles or watercraft owned in the name of a LLC or Trust?
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Life Style
Are you interested in learning more about Life Insurance, Long Term Care and/or Disability Insurance?
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If you are currently working with a Wealth Manager or Family Office, would you like them to be included in your annual insurance review?
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If you travel frequently, would you be interested in travel insurance?
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Are you interested in learning more about Identity and Cyber Fraud exposures?
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Please share with us any unique hobbies or interests that may require some additional insurance solutions.
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Please take a moment to review the form to ensure accuracy and completeness before submitting!
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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From Our Blog From Our Customers
      

Unlike working with a captive or exclusive agents, independent agents work for you, not for the company that currently underwrites your policy. That affords us a lot of flexibility with servicing your account.

When you represent only one company, the rules are pretty straight-forward. There is one company, one set of underwriting rules and one set of rates. This limits their ability to provide options.  Independent agents work with multiple carriers allowing us to move your coverage when a better fit is needed.

                         
   
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