Auto Insurance Checklist

To assist us conducting an Annual Insurance Review, we have prepared the following form.  Please complete, it should take about 15 minutes to complete.  Once we have reviewed the form, we will get back to you with any coverage recommendations or available discounts.

Acknowledgement of Insurance Review

Please select from below: *

Policy Questions

1. Has your marital status changed?
2. Have you purchased, sold, or leased any vehicles?
3. Does anyone on your policy use their vehicles for business?
If yes, are they insured with a business/commercial policy with Fish-Johnson?
4. Any vehicles used to deliver goods (mail, pizza, newspapers)?
5. Any vehicles used to transport people for a fee (Uber, Lyft, etc.)?
6. Do any vehicles have custom equipment?
7. Have any car loans or leases been paid off during the current policy term?
8. Have the miles driven to work changed for any driver?
9. Are any licensed drivers residing in your home that are not listed on the policy?
10. Do all drivers live at the insured address?
11. Are there any full-time students that achieve a 3.0 GPA?
12. Are there any drivers away at college without a car?
13. Do any drivers have access to non-owned vehicles?
14. Do we insure all autos in the household?
15. Are any vehicles titled in someone else's name?
16. Are any vehicles driven under 7,000 miles a year?
17. Do you own any Classic or Antique cars?
18. Are any vehicles used in racing?
19. Do any vehicles have a salvage title?
20. Do you own any utility or camping trailer?
21. Are any vehicles or trailers not kept at home?
22. Do any vehicles have safety features, such as adaptive headlights, anti-lock brakes, autonomous operation mode, back-up warning, driver fatigue sensing, forward-crash avoidance with or without auto brake, lane departure with or without blind-spot monitoring?
23. Do any drivers not have a valid drivers' license?
24. Do you have an Umbrella Liability Policy?
25. How would you like us to communicate any recommendations or discounts available to you regarding this review?
26. Could Fish-Johnson Insurance offer you a quote on any of the policies below?
28. Are you aware that when you refer someone to Fish-Johnson Insurance to quote their insurance, we send you $10? It is our Referral Program, so be sure to have them give us your name when they call for a quote. It's our way of thanking you for referring us to your friends, relatives, and neighbors.