AUTO INSURANCE UPDATE The purpose of this Form is to make sure your policy is up-to-date so we can help you avoid coverage gaps. What's a coverage gap? No coverage when you need it! Name(Required) First Last Your Email (person completing the form).(Required) Updated emails and cell phone numbersIf you think we might have old information, please give us updated information starting with the person's name. Any name changes?If you've changed your name, let us know so we can update it.Marital Status Change:If you've changed your marital status to married, single, separated, etc. We need to update the policy, some insurance companies will deny claims if the policy is not reflecting correct information. Mailing or Garaging Address Change:If the address shown on your policy is different, let us know your current address where the vehicles are garaged. Some policies will DENY coverage if the address is not accurate. TIP: Keep your driver's license address up-to-date.Did you know - the BMV requires that your driver's license address be updated within 10 days of moving! Make sure your driver's license reflects your current address! The BMV could send an important notice in the mail and if your address is not correct, you'll be unable to respond. Many people have had their driver's license suspended without knowing it because they didn't receive the written notice. Don't let this happen to you. Additionally, some insurance plans require that the driver's license address match the insurance policy address (Progressive) is a carrier that makes this requirement. Drivers in your household:The policy intends to cover YOU and your listed drivers. If there is anyone else living with you, we need more information to make sure you and your listed drivers are covered if they drive that person's auto. (If the person living with you drives your auto(s), they would need to contact their insurance company to see if their policy would protect them too). Drivers - Any youth getting ready to get their learner's permit?Provide their name, date-of-birth and estimated date they'll be getting their permit. Are there drivers with autos, (you live with) not listed on your policy?(Required)The policy restricts coverage when a person (YOU and YOUR listed drivers) drives a car that is 'furnished" for regular use. This happens when you live with someone who owns a car. To make sure you are covered, should you drive their car, we need to know if this applies to you. Do you live with someone, who is not on your policy, where they have their insurance elsewhere? Not applicable Yes and they have insurance Yes, they have no insurance Employer owned, Company Car Do you or your listed drivers drive a car owned by someone you Do Not Live With, on a regular basis?(Required)We need to know if you or your listed drivers ever drive the auto owned by the person who lives with you, who we do not insure. (Previous question). Not applicable We do not drive their vehicle Sometimes Are any of the listed drivers: graduating, getting married or moving out?The policy covers youthful drivers up until the point they live with you including while in college. Once they graduate and/or move into their own place, the policy takes away coverage automatically. This is very important and something we need to know so we can help fix the gap! Is a driver(s) graduating college in 2026/2027 Not applicable Yes No Is a driver(s) moving out?Please let us know driver's name and the car they have. No Yes If so, what is the driver's name and what car do they primary drive?Please provide their name and wedding date:Is a driver engaged to be married? No Yes This section is specific to your vehicles:Below are a variety of questions concerning drivers in your household, people who might live with you that aren't on your policy, ownership of the cars, and more. Your answer will help us determine if there are any coverage gaps we need to close. We will let you know if we find any based on your answers. After a review of your answers, we will contact you if your policy needs to be updated.Ownership - Who owns the cars?The policy assumes the cars are owned by the Named Insured. The named insured is the person shown just above the address. Who owns the autos (Titleholders)(Required)The policy assumes the car is owned by YOU or your spouse listed as the Named Insured. If a listed driver, (for example - a youthful driver) owns a vehicle let us know. Not applicable. I own the vehicles. Just owned by insured Owned by someone else Cars owned by someone other than YOU or spouse.List the owner's name and Year and Make of the car.Transportation Network Company (Uber, Uber Eats, Lyft and others), or use of a vehicle not owned by you.Are there any drivers, including yourself, using a car to deliver people or property for a fee? This activity is NOT covered in the auto policy. But, I could be with the proper endorsement.Rental Reimbursement(Required)First, look at the limit shown in the email for rental, then answer below: Yes, increased to the next limit available No, keep my limit the same I don't have Rental on my cars Do any of the drivers, including yourself, drive for any mobile app network service like Uber Eats, Uber, Lyft, etc?(Required) No Yes Provide the name of driver and the car used for the network service:Do any driver listed in the policy deliver for a local business or restaurant like delivering pizza?(Required) No Yes Provide name of driver using their car to deliver for a local business.Physical Damage on your older autosWhen the auto has high miles, is older or both, it may be time to remove the physical damage coverage. Do any of your vehicles listed on the policy have over 100,000 miles? No Yes Would you consider removing physical damage?Physical Damage is "other than collision/comprehensive" and collision as well as Roadside and Rental. No Yes List car you'd like to remove physical damageHave you paid any of the vehicles off in the past two years? No Yes List the year and make of the vehicle and we will make sure the lender has been removed.Do you own any of the following type vehicles NOT insured: (Coverage is not automatic from either the auto or home policy) Travel Trailer or Utility Trailer Motorcycle, Scooter, Quad or ATV, Golf Cart Any type of E-Device: bike, scooter, Segway, etc. Anything designed for road or off road use Snow mobile, Jet Ski, Boat of any type Drone or any hobby aircraft Leave a comment below to help us know more about you and your family or a comment to help us serve you better:hCaptcha(Required)UntitledUntitled
