Renewal Review Form PL

    Renewal Review Form

    Personal Information

    Is there another name/individual associated with this account?

    If yes, name of individual listed:

    Preferred Method of Contact


    With the cost of reconstruction today, do you feel the need to increase coverage on your home or structures not attached to your home? (Property valuations are the responsibility of the owner, but we have tools to assist you. Please contact us if you wish to discuss.)

    Have you recently installed Central Station burglar or fire alarms?

    Do you conduct any business (including childcare) or give lessons in your home?

    If you rent or own a condo, do you have renter's or condo insurance?

    Has your mortgage been recently paid off or sold to another financial institution?

    Does any driver use a vehicle in their job other than to drive to and from work?

    Does any driver have a vehicle furnished for their regular use, such as a company car?

    Are you interested in towing and labor or rental car coverage in the event your vehicle is damaged in an accident?

    Is any vehicle equipped with customized equipment such as stereo equipment, grill guards, running boards, a camper topper or handicapped adaptive equipment?

    Do you have young drivers in your household who may qualify for a Good Student Discount?

    Has your car loan been recently paid off?

    Do you own a snowmobile, boat, trailer, ATV, golf cart, motorcycle, etc?

    Are you interested in learning more about the availability of additional personal liability or auto liability coverage?

    Are you interested in signing up for our new online Customer Portal - where you can access your insurance information 24/7?

    How would you rate the service our agency provides?

    What can we do to make your experience with us even better?

    Please include any other comments you would like to share.

    Thank you for your time. We value our client's input and strive to make every interaction helpful and positive!