Homeowner Renewal Questionnaire
Please answer questions below so we can make sure you have the correct coverage and/or discounts available to you.
First Name: *
Last Name: *
Best contact phone number for you? *
Your email address: *
If you don't have one, just put N/A.
1.) Have you had any recent changes in your home address, employment or marital status?
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If so, please list change(s) below:
2.) Have you recently remodeled or added any updates to your home? (new roof, wiring, heating system, plumbing, added an addition, built any detached structure such as a garage or outbuilding, finished your basement, etc.)
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If so, please list any changes below:
3.) Have you paid off your mortgage, refinanced, changed your mortgage company or taken a second mortgage?
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If so, please list any changes below:
4.) In order to make sure that you are receiving maximum discounts, please indicate if you have the following in your home: burglar alarm (monitored) or fire alarm (monitored).
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If so, please list which one(s) and provide us with a copy of the certificate to submit to your insurance company for the discount.
5.) ALERT! Every insurance policy has internal sum-limits. Do you own some of the following and need a quote for scheduling these on your policy (you will need a copy of the appraisal or receipts for over $2,500): Jewelry, Antiques, Guns, Furs, Fine Art, Silverware, Goldware, Collectibles, Home Computer, Coin or Stamp Collection, Camera or Photo Equipment, Money/Bank Notes/Bullion/Gold, Securities/Accounts/Deeds/Letters of Credit, Property used for Business Purposes on Premises, Property used for Business Purposes away from Premises?
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If you have any of those items, please list which ones to receive a quote in order to insure those items:
6.) Do you rent any part of your home or other buildings on your property to anyone?
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7.) Have you acquired any pets?
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If so, please list what breed(s) they are:
8.) Have you installed a swimming pool, trampoline, or wood burning stove?
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9.) WARNING! Your homeowners policy DOES NOT automatically provide coverage for FLOOD or EARTHQUAKES. Most people think of rising streams, lakes, rivers, and oceans when they think of flood. But most flood claims are caused by a large amount of rainfall in a short period time that causes standing groundwater to infiltrate your home.
Would you like us to provide you a quote for flood or earthquake insurance?
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10.) ALERT! Business conducted at your home is not automatically covered if you get sued including home based businesses, studios, offices, private lessons, and babysitting. Has any member of your household started a business in your home?
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11.) Do you own the following: automobile, vacation home, secondary home, condominium, rental property, investment property, boat, jet ski, airplane, snowmobile, recreational vehicle (ATV, go-cart, motorcycle, golf cart, etc.)?
Would you like us to quote any of those items? If so, please list which one(s) below:
12.) Do you own a business not insured by us?
If so, would you like a commercial quote?
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13.) Have you filed any claims in the last year?
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14.) Would you be interested in an Umbrella Liability policy to protect your assets if you are sued?
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15.) If you don't have health and/or life insurance, would you like us to contact you for a quote?
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16.) If you would like further review or have questions regarding your policy(s), please let us know when the best time to contact you and your preferred method of contact.
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