Annual Account Review

Annual Account Reviews are a vital step in making sure that all of your information is up to date so that you, your loved ones, and all of your important possessions are properly covered.

Use the Form below to see if there any updates you need to make to your information and if so, we will then perform a full, comprehensive review of your policies and coverages including requoting them to make sure you are still getting the best price and coverages available to meet your needs.

"*" indicates required fields

Name*

First Last

Phone*

Email*

Which Policy(s) do you need to Review/Update?*

Please check all that apply

Home Policy

Auto Policy

Has your Marital Status changed since our last review?*

Yes

If Yes, please select your Updated Marital Status*

Has there been any changes to any of the Financing in place for your Home?*

This can include new Mortgages, 2nd Mortgages, Lines of Credit, etc.

Yes

If Yes, please provide the details here*

Has your Home undergone any modifications that increase the value above its current insurable limit?*

Changes could include renovations, remodeling, additions, newly built garages, etc.

Yes

If Yes, please provide full details below including the scope and approximate value of work completed*

Are any of the Properties you own, in whole or in part, rented or leased to others?*

This may include the Entire Home, Basement Suites, One Side of a Side by Side Duplexes, etc.

Yes

If Yes, please provide complete details*

Details may include rental agreement terms, rental income, etc.

Are you running any type of Business out of your Home?*

Yes

If Yes, please provide complete details*

Ex. Type of Business Operation, Percentage of Home used for Business, Value of Equipment/Goods on premises, etc.

Are you looking for more information about additional coverages that may be available for your Home?*

Ex. Flood or Overland Water, Service Line Coverage, Identity Theft Coverage, Property in Storage, etc.

Yes

If Yes, Let us know which Coverages you'd like to learn more about*

Are you considering increasing your Deductibles on your Home Policy to help lower your premiums?*

Yes

Has there been any changes to any of the Financing in place for your Vehicle(s)??*

This can include new Lienholders, Lessors, etc.

Yes

If Yes, please provide details here*

Are there newly licensed members of the family in the home that will be driving the Vehicle(s)?*

Ex. Child has gotten their Class 5 GDL, a Relative has moved into the home, etc.

Yes

If Yes, please provide details below*

Have you purchased a new Vehicle that you need to add to your current Policy?*

Yes

If Yes, please provide the vehicle details below including the VIN and coverages required*

Has there been a change of use for your vehicle(s)?*

Ex. Employment Status has changed, Commute Distance has changed, Business Use, Commercial Use, etc.

Yes

If Yes, please provide the details below*

Are you looking for more information about additional coverages that may be available to you?*

Ex. Collision Coverage, Comprehensive Coverage, Accident Forgiveness, Limited Waiver of Depreciation/Replacement Cost, etc.

Yes

If Yes, Let us know which Coverages you'd like to learn more about*

Have you considered increasing your Deductibles on your Auto Policy to help lower your premiums?*

Yes

Do you own or have you purchased any Motorcycles, ATVs, Mini-Bikes, Mopeds, Motorized Scooters, Campers/Travel Trailers, Motorhomes or Golf Carts that need to be added to your insurance policy?*

Yes

If Yes, please provide the details below...*

Additional Comments/Questions

Acknowledgement*

Submitting this form in no way binds any coverage or changes to your existing insurance contract for the Applicant or Company however it is agreed that this form May form part of the contract should a policy (or policy Change) be issued though our agency. It is extremely important that you always discuss these changes with a licensed insurance representative after submitting this online.*

I understand the above acknowledgement

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