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1Start
2Vehicles
3Drivers
4Insurance
5Renters
6Coverages
7Your Policy
Name
MM slash DD slash YYYY
Mailing Address
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Vehicle section 1

I also use this vehicle for Ridesharing
Equiped with an anti-theft device?
Vehicle 2
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Vehicle section 2

I also use this vehicle for Ridesharing
Equiped with an anti-theft device?
Vehicle 3
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Vehicle section 3

I also use this vehicle for Ridesharing
Equiped with an anti-theft device?
Vehicle 4
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Vehicle section 4

I also use this vehicle for Ridesharing
Equiped with an anti-theft device?
Vehicle 5
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Vehicle section 5

I also use this vehicle for Ridesharing
Equiped with an anti-theft device?
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Driver section 1

Gender
Type in the name of health insurance carrier

Residency

Driving History

Accidents, Violations and Claims

As a driver in the last 5 years (since Apr '17), have you had any (regardless of fault):

Accidents, claims, or other damages you had to a vehicle?
Select One or Multiple Incidents
Tickets or Violations?
Select One or Multiple Violations
Driver 2
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Driver section 2

Gender
Type in the name of health insurance carrier

Driving History

Accidents, Violations and Claims

As a driver in the last 5 years (since Apr '17), have you had any (regardless of fault):

Accidents, claims, or other damages you had to a vehicle?
Select One or Multiple Incidents
Tickets or Violations?
Select One or Multiple Violations
Driver 3
This field is hidden when viewing the form

Driver section 3

Gender
Type in the name of health insurance carrier

Driving History

Accidents, Violations and Claims

As a driver in the last 5 years (since Apr '17), have you had any (regardless of fault):

Accidents, claims, or other damages you had to a vehicle?
Select One or Multiple Incidents
Tickets or Violations?
Select One or Multiple Violations
Driver 4
This field is hidden when viewing the form

Driver section 4

Gender
Type in the name of health insurance carrier

Driving History

Accidents, Violations and Claims

As a driver in the last 5 years (since Apr '17), have you had any (regardless of fault):

Accidents, claims, or other damages you had to a vehicle?
Select One or Multiple Incidents
Tickets or Violations?
Select One or Multiple Violations
Driver 5
This field is hidden when viewing the form

Driver section 5

Gender
Type in the name of health insurance carrier

Driving History

Accidents, Violations and Claims

As a driver in the last 5 years (since Apr '17), have you had any (regardless of fault):

Accidents, claims, or other damages you had to a vehicle?
Select One or Multiple Incidents
Tickets or Violations?
Select One or Multiple Violations

Tell us about your insurance..

Auto Insurance History

Do you have auto insurance today?
Have you had auto insurance in the last 31 days?

Your place

Address of the place you're insuring
Do you own or keep animals?
Is this also your mailing address?
What is your mailing address?

Your info

Your name
Used for sending info about your quote. We won’t sell or share your email address with anyone else.
MM slash DD slash YYYY
When do you want your insurance policy to start?

What's covered

We're suggesting the most common coverage amounts
Pays for your stuff (furniture, electronics, clothes, etc.) if items are stolen or damaged by covered events. How much would new stuff cost? Enter that amount in whole numbers with $500 increments.
$2,500 is already included, but you can add more. Are all of your computers, tablets, software, printers, etc. worth more than $2,500 combined? If so, select the total coverage amount you want instead.
For example: if someone is hurt at your place, they could sue you. Subject to some limitations, this coverage would pay for your lawyer, court fees and any damages for which you are legally liable/responsible.
Pays for medical bills if someone else is hurt at your place. Unlike Liability, no one has to sue you for this to kick in.

Your out-of-pocket costs

If you have a covered loss, you pay this much and we pay the rest, up to your coverage limits.

Enhanced coverage

Adds coverage for overflowing water, libel/slander, and increases certain amounts of coverage.

Enhanced coverage package includes

Personal Injury

Provides coverage for a variety of uncommon but expensive situations:

  • Slander or libel lawsuits (something you say/write that damages a person’s reputation or business)
  • False arrest, detention or imprisonment
  • Wrongful/malicious lawsuits against you
  • Wrongful eviction

$5,000 for overflowing water (Water Back-up)

Sometimes plumbing/sewer systems or sump pumps can get backed up, which can cause significant damage and an expensive mess. This coverage pays for damage to personal property and water removal.

Adds and increases coverage

  • Adds $5,000 more for computers (on top of what you already selected)
  • Increases coverage for bicycles to $5,000

Your discounts

You'll get a discount for each "yes"
This means you have to drive by a security guard or use a key or remote to enter the complex/community.
This means you'd pay for your entire 12-month policy upfront.

Insurance history

You can find this within your existing insurance documents.
Don't include wind, hail or lightning claims.
Do you live with AND want to include a spouse/partner?
Name
Does your landlord/apartment need proof of insurance?
Called additional interest. This lets them know you have insurance or if you make any changes. If they require this, they’ll likely tell you.
Address

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