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Umbrella Renewal Review Questionnaire

Umbrella Renewal Review Questionnaire

We continue to appreciate your business and providing for your insurance needs. Your current policy(ies) will renew soon, and we need your assistance in order to make sure that we remain current with your insurance program. Please take a few minutes to complete the following survey and mail or fax it to us within the next two weeks, or you can call us during normal business hours with your responses and or questions. If we do not receive an updated application, completed questionnaire, or if we do not hear from you, we will proceed as if there are no changes needed to your insurance needs and we will renew the policies with the same coverage terms as the expiring policy(ies).

    Please select "YES" or "NO" to the following questions so that we may update your policy if necessary. Thank you for your continued business!

    1. Have you or any member of your household acquired new property since the inception of this umbrella policy?

    2. Please provide a numerical answer for property owned by you or any member of your household:

    3. How many total drivers are in the household?

    4. How many drivers are under the age of 22?

    5. How many drivers are over the age of 70?

    6. How many moving violations?

    7. How many at fault accidents?

    8. Has your underlying policy information changed?

    9. Please specify your homeowners insurance carrier & coverage information in the box below:

    10. Please specify your auto insurance carrier & coverage information in the box below:

    11. Please specify your watercraft insurance carrier & coverage information in the box below:

    12. Please specify any other insurance carriers & coverage information in the box below:

    13. Do you prefer to be contacted via e-mail?

    Thank you for taking the time to complete this questionnaire. Please let us know if you have any questions regarding your policy renewal.