Auto Policy Protection Checklist

61% of claims Denied by insurance companies result from unreported changes and unreported property or vehicles.

Five minutes of your time to complete this auto policy protection checklist questionnaire will help eliminate claims problems.

There are no wrong answers and your response will enable us to discuss coverage concerns and provide recommendations for your auto insurance renewal.

Complete and submit the form below and a personal lines insurance agent will follow up with you to discuss your auto policy renewal.

We thank you for your business and look forward to hearing from you soon! 

You can also print the form and mail or fax back to our office.

Auto Policy Protection Checklist

Please note that all fields followed by an asterisk must be filled in.
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No
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N/A
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No
Yes
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Already Have Coverage
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Already Have Coverage
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Already Have Coverage

Please enter the word that you see below.

  



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