Personal Lines Renewal Questionnaire in San Antonio, TX

Personal Lines Renewal Review

"*" indicates required fields

This field is hidden when viewing the form

Primary Producer

Let's Verify the Basics

CSR*

Person completing this form:*

Today's Date*

MM slash DD slash YYYY

Name*

Enter the name listed first on your insurance policies

First Last

Please confirm your best email.*

This is the email we send policy notifications to.

Is this your best phone number?*

Check if applicable:

Spanish speaker only

Preferred Contact Method*

What is your occupation?

Are you married?*

Yes

What's your spouse's full name?*

Spouse's date of birth*

MM slash DD slash YYYY

What's your spouse's email?

What's your spouse's phone number?

What is your spouse's occupation?

Please confirm your address to verify we're working on the right profile:*

Street Address City State / Province / Region ZIP / Postal Code

This field is hidden when viewing the form

Google Maps Link:

This field is hidden when viewing the form

Website

Policies CURRENTLY have with My Insurance Group?*

Personal Auto

Homeowners

Landlord

Flood

Renters

Stand Alone (Texas Windstorm)

Personal Umbrella

Watercraft

Recreational Vehicle / Travel Trailer

Motorcycle / ATV / UTV

Life Insurance

Personal Auto

Confirm all Drivers needing to be on policy:*

All Household Members Over The Age of 15.

Confirm all Vehicles needing to be on Policy:*

Did you add any custom parts or equipment over $1000?*

Are any vehicles on the policy used for transportation for hire, such as Uber or Lyft?*

Yes

Please list the vehicle(s) used for Rideshare*

Our clients save 18% annually when completing carrier telematics generally within 90 days. Are you interested? By the way, you can opt out so don't be nervous.*

Yes

Insureds who pay in full can save up to 10%. Are you interested?*

Yes

Are you open to increasing your deductibles to save money?*

Yes

Do you have any additional questions, concerns, or feedback regarding your auto insurance policy?*

Yes

Please Describe your Questions, Concerns, or Provide Any Feedback.*

Homeowners

Who is your mortgage company? We need to make sure the right company receives the renewal invoice.*

In the last year, any changes in your mortgage company information?

Any home updates or improvements?

Have there been any additions or updates to your home? Ex pool, solar panels, remodeling, additions, updates to the water, heating, plumbing, electrical or roof

Yes

If Yes, Please provide a value and description for all improvements*

What year was your roof last replaced?*

It's imperative to have the roof age when addressing carrier appetite.

Home Sharing

Do you rent your home as part of a home-sharing or short term renting program like AirBnb, VRBO or other?

Yes

Do you have any pets?

Yes

Please describe the number, type, and breed of pets (if dogs)*

Are you open to increasing your deductibles to save money?*

Higher deductibles have lower premiums. Higher deductibles also means more money our of YOUR pocket in the event of a claim.

Yes, let's talk about other deductible options.

No, I'm not comfortable increasing my deductible in the event of a claim.

SIMPLE DISCLAIMER*

In the event of a remarket opportunity, we want to make sure we're crystal clear on the exterior inspection expectations.

The carrier will have a 3rd party inspector come to the property about 30 days after the policy starts. They will be looking at the overall condition to include but not limited to:

Branches/limbs/trees overhanging the roof line.
Roof conditions such as granular loss, lifting, curling, missing shingles, etc.
Cracks in your driveway or other concrete paths to your house.
Exterior siding conditions such as peeling paint, missing siding, holes in siding
Fence issues such as missing planks, falling, rotten, etc.

The carrier will require you to acknowledge and repair any of the issues reflected on the inspection report. Please discuss any questions with the agent assigned to your renewal journey.

By checking this box, you are acknowledging paragraph below:

Do you have any additional questions, concerns, or feedback regarding your home insurance policy?*

Yes

Please Describe your Questions, Concerns, or Provide Any Feedback.*

Landlord / Rental Property

Who is your mortgage company? We need to make sure the right company receives the renewal invoice.*

Have there been any recent changes in your mortgage company information?

Any home updates or improvements?

Have there been any additions or updates to your home? Ex pool, solar panels, remodeling, additions, updates to the water, heating, plumbing, electrical or roof

Yes

If Yes, Please provide a value and description for all improvements*

What year was your roof last replaced?*

It's imperative to have the roof age when addressing carrier appetite.

Home Sharing

Do you rent your home as part of a home-sharing or short term renting program like AirBnb, VRBO or other?

Yes

Are you open to increasing your deductibles to save money?*

Higher deductibles have lower premiums. Higher deductibles also means more money our of YOUR pocket in the event of a claim.

Yes, let's talk about other deductible options.

No, I'm not comfortable increasing my deductible in the event of a claim.

DISCLAIMER*

By checking this box, you are acknowledging paragraph below:

Personal Umbrella Policy

In the last year, any significant changes to your net worth that may require an adjustment in your personal umbrella policy coverage limits?

Yes

If yes, please explain:

In the last year, have you purchased any property that may require an adjustment in your personal umbrella policy coverage limits?

Yes

What are the addresses to be added and primary use?

Have you added or changed any recreational vehicles, boats, or other toys that might warrant additional liability coverage under your personal umbrella policy?

Yes

If yes, please list:

Any changes in your household, such as new drivers, family members moving in or out, or changes in employment status, that could affect your personal umbrella policy coverage?

Yes

If yes, please explain:

Watercraft Policy

Have you made any modifications or purchased new equipment for your watercraft in the past year that may require an update to your policy?

Yes

If yes, please explain to include value:

Has your watercraft usage changed, such as frequency of use, different bodies of water, or participating in new activities (e.g., water sports, fishing, or chartering), which may impact your policy?

Yes

If yes, please explain:

Have there been any changes to the storage or mooring location of your watercraft, or have you transported your boat to new locations that might affect your watercraft policy?

Yes

If yes, please explain:

RV / Travel Trailer

Have you made any upgrades or purchased new accessories for your RV or travel trailer in the past year that may require updates to your insurance policy?

Yes

If yes, please explain to include value:

Has there been a change in frequency of use such as taking longer trips, participating in new activities, or riding in different locations, that could affect your insurance policy coverage?

Yes

If yes, please explain:

Are you renting your RV or Travel Travel to others?

Yes

Are you using a program such as RVshare or Outdoorsy?

Yes

Motorcycle / ATV / UTV

Have you made any upgrades or purchased new accessories for your motorcycle or ATV/UTV in the past year that may require updates to your insurance policy?

Yes

Please explain:

Life Insurance

Have there been any life events in the past year such as marriage, divorce, birth or adoption of a child, or a change in dependents that could affect your life insurance coverage needs?

Yes

Please explain:

Have you experienced any changes in your financial situation such as an increase in income, assets, or debt that might warrant a re-evaluation of your policy coverage amount or type?

Yes

Please Explain:

Have you made any updates to your estate plan or designated beneficiaries for your life insurance policy in the past year?

Yes

Please explain:

Do you need assistance reviewing or updating this information to ensure it is accurate and up-to-date?

Yes

Finally...

What policies do you have OUTSIDE of My Insurance Group:*

Policies you have elsewhere.

Auto

Rental Property(ies)

Personal Umbrella

RV or Travel Trailer

Homeowners

Life / Mortgage Protection

Flood

Watercraft

Motorcycle or ATV

Farm or Ranch

Business/Commercial

None at this time

Send Canopy Link

Personal Auto

Who's your current auto carrier:*

Please select your carrier from the list

Please insert your auto carrier's name here:*

What kind of vehicles do you have?

Year, make, and model

Who are the household members of driving age?

Name and date of birth

How much are you paying monthly from your auto insurance?*

Landlord / Rental Property

How many rental properties do you own?*

Addresses of all rental properties:

Who's your current rental property carrier:*

Please select your carrier from the list

Please insert your rental property carrier's name here:*

Do you use this property for short term rentals such as AirBNB or VRBO*

Yes

Do you require the tenants to have tenant insurance?*

Yes

Are the property(ies) professionally managed?*

Yes

Homeowners

Who's your current home insurance carrier:*

What's your current home insurance premium:

When was your roof last replaced?*

Newer roofs create discounts and increase carrier appetite.

RV / Travel Trailer

Who's your current RV / Travel Trailer insurance carrier:

Please insert your RV / Travel Trailer carrier's name here:

What kind of RV/Travel Trailer do you have?

Year, make, and model

Do you use a rent your RV / Travel Trailer to others?*

Yes

Do you use a rental program such as RVShare or Outdoorsy?*

Yes

How much are you paying monthly?*

Watercraft

Who's your current watercraft insurance carrier:

Please insert your watercraft carrier's name here:*

What kind of watercraft do you have?

Year, make, and model

How much are you paying monthly?*

Motorcycle / ATV / UTV

Who's your current Motorcycle / ATV / UTV carrier:

Please insert your Motorcycle / ATV / UTV carrier's name here:*

What kind of Motorcylce / ATV / UTV do you have?

Year, make, and model

How much are you paying monthly?*

Farm or Ranch

Who's your current Farm or Ranch carrier:

Please insert your Farm or Ranch carrier's name here:

What activities are you doing on your farm or ranch?

Farming, Hunting, etc..

Business / Commercial

What kind of business do you own?

Schedule the follow up call now:

Schedule Follow-up Call

Notes / Feedback for the Agent

This field is hidden when viewing the form

VA Completing Form

This field is hidden when viewing the form

AZ Assigned Producer

This field is hidden when viewing the form

AZ Assigned CSR

"*" indicates required fields

Team Member*

First Name

Phone