Your Auto Renewal Is Coming Up!

Emily Smith, CSR/Agent

You are a valued client and we are constantly striving to find creative and innovative ways of delivering excellent customer service to you.

Because life changes,  your insurance needs change too and we feel it’s very important to check with you regularly to make sure we have up-to-date information to ensure you’re properly covered.

We have a very short questionnaire for you to complete. It should only take about 2-3 minutes to complete and will greatly help us keep your info up-to-date. Thanks for your cooperation and participation!

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    Your name

    Street address

    Your preferred email

    Best phone number to reach you

    Please indicate your current marital status.

    Spouse's first and last name

    Best phone number for spouse.

    Email address for spouse.

    Auto Questions

    Since your last review...

    Are there any newly-licensed drivers or any drivers no longer in household?
    yesno

    Has a student moved away to college (100+ road miles) without the use of a vehicle?
    yesno

    Have you, or any driver, changed job or school locations or work from home?
    yesno

    Please provide more details:

    Does any household driver participate in any ridesharing activities? (Uber/Lyft driver, Door Dash, UberEats,etc)

    Please let us know which vehicle(s) are used

    Have any insured vehicles been customized or altered?
    yesno

    Please provide more details:

    Have you paid off any vehicle loans this past year?
    yesno

    Which loan(s) are paid off?

    What is the total number of vehicles registered to you and/or your spouse/significant other? (REMEMBER- you should not insure vehicles not registered to you/mate.)

    Would you be interested in bundling your homeowner's or renter's insurance with your auto?  multi-policy discounts can save you up to 40%!
    yesI already dono

    Have you considered increasing your liability limits for better protection of your assets?
    yes, more info pleaseno thanks

    Your insurance company has additional coverage options for auto you might be interested in.
    (select your company below and choose the coverage(s) you would like more info about)

    comprehensivefull glass $0 deductiblecollisionroadside serviceloss of use (rental car)new auto securityrideshare gap (Uber/Lyft)rate lockauto plus (dim. deductibles)not interested

    comprehensivefull glass $0 deductiblecollisionroadside assistanceloss of use (rental car)special equipmentloan/lease gap coveragenot interested

    comprehensivefull glass $0 deductiblecollisionroadsideloss of use (rental car)ID theftpet injurymobile devicesnew auto replacedeductible waiverloan/lease gapcustom equipmentrideshare gapminor violation forgiveaccident forgivenessnot interested

    comprehensive$50 glass deductiblecollisionroadsideloss of use (rental)loan/lease gapincreased custom equiplimited mexico coverageRDP accident/viol forgivePRDP (+dim deducts)new car replacementIntelliDrive savingsnot interested

    comprehensivefull glass $0 deductiblecollisionroadsideloss of use (rental)loan payoffincreased custom equipSnapShot savingsdiminishing deductiblespaperless discountnot interested

    comprehensivefull glass $0 deductiblecollisionroadsideloss of use (rental)accident forgivenessworld-wide rentalloan/lease gapnew vehicle replacementcustom equipemergency assistancerideshare (Uber/Lyft)claims free cash backnot interested

    full glass $0 deductiblenot interested

    full glass $0 deductibleenhanced collisionroadsidetrip interruptionloan/lease gapaccident forgivenesspet injurynot interested

    With regards to life insurance, select all that apply to you.

    How would you rate our service to you?
    below averageaverageabove averagesuperior

    Are there any areas you feel we could improve upon in providing service to you?
    noyes

    We welcome your feedback...

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