JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Identify Risk from Coverage Gaps
Most r
esidential & commercial property o
wners have unfair
provisions
in their insurance policy
and will not find out
until
they have a claim and
it's too late.
Take a minute to answer this short questionnaire.
We don't sell insurance
We don't sell your information
Sign in to Google
to save your progress.
Learn more
* Indicates required question
In which State do you reside?
*
Choose
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawai'i
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
When buying your policy, did your agent visit the property to help ensure you are covered properly?
*
YES
NO
NO, I purchased over the internet / phone
What is the reason you have the insurance policy you have today?
*
It was the least expensive
I thought it was the best coverage for the best price
My mortgage company chose it
A friend / family member started selling insurance
It's used by friend / family member
When was the last time you called your insurance company about damage, whether it was denied, paid or under the deductible?
*
I've never had a claim
Less than 6 months ago
6-12 Months ago
Over a year ago
I have damage but it isn't worth the claim
Part of what we do is educate people on gaps in their policy before they have a claim and it is too late. If you have coverage gaps, would you be open to having a discussion so we can give you professional advice for you to discuss with your agent?
We don't sell insurance or anything else.
*
Yes, as long as it's free
No
If you are owed money by your insurance company, would you want to know?
*
I don't think I have damage.
Yes, I have damage but I was told it wasn't covered
Yes, I have damage but it doesn't meet my deductible
Yes, I had a claim that was denied / underpaid in the last year
Yes, I have an eye sore
No
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms