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Sykesville, MD and Eldersburg, MD Auto Insurance
Taneytown, MD Auto Insurance
Westminster, MD Auto Insurance
Boat Insurance
Home Insurance
Howard County, MD Home Insurance
Seasonal Home Insurance
Jewelry Insurance
Life Insurance
Motorcycle Insurance
Rental Insurance
Umbrella Insurance
Home & Auto Bundle
Business Insurance
Salon Insurance
Business Auto Insurance
Property Insurance
Liability Insurance
Cyber Insurance
Workers Compensation
Technology Errors & Omissions
COI Request
Access Your Account
Fifty For Friends
File A Claim
Policy Change
Toggle Navigation
About Us
Our Team
Careers
Our Blog
Community Involvement
Videos
Personal Insurance
ATV Insurance
Auto Insurance
Finksburg, MD Auto Insurance
Hampstead, MD Auto Insurance
Howard County, MD Auto Insurance
Sykesville, MD and Eldersburg, MD Auto Insurance
Taneytown, MD Auto Insurance
Westminster, MD Auto Insurance
Boat Insurance
Home Insurance
Howard County, MD Home Insurance
Seasonal Home Insurance
Jewelry Insurance
Life Insurance
Motorcycle Insurance
Rental Insurance
Umbrella Insurance
Home & Auto Bundle
Business Insurance
Salon Insurance
Business Auto Insurance
Property Insurance
Liability Insurance
Cyber Insurance
Workers Compensation
Technology Errors & Omissions
COI Request
Access Your Account
Fifty For Friends
File A Claim
Policy Change
Toggle Navigation
About Us
Our Team
Careers
Our Blog
Community Involvement
Videos
Personal Insurance
ATV Insurance
Auto Insurance
Finksburg, MD Auto Insurance
Hampstead, MD Auto Insurance
Howard County, MD Auto Insurance
Sykesville, MD and Eldersburg, MD Auto Insurance
Taneytown, MD Auto Insurance
Westminster, MD Auto Insurance
Boat Insurance
Home Insurance
Howard County, MD Home Insurance
Seasonal Home Insurance
Jewelry Insurance
Life Insurance
Motorcycle Insurance
Rental Insurance
Umbrella Insurance
Home & Auto Bundle
Business Insurance
Salon Insurance
Business Auto Insurance
Property Insurance
Liability Insurance
Cyber Insurance
Workers Compensation
Technology Errors & Omissions
COI Request
Access Your Account
Fifty For Friends
File A Claim
Policy Change
Internal Form
cyinsurance
2023-05-03T06:24:07-04:00
Internal Form
Internal - Quick home quote
Can I start with getting your first and last name please?
*
First
Last
How did you hear about us? (Lead Source)
What's prompting you to look at your insurance? (SKIP this if purchasing)
(We're looking for pain points with their current policy - are they looking for a lower price, did they experience bad service, poor claims experience? )
How many other agents have you been in contact with?
Other than price, why are you shopping for Insurance?
How much are you currently paying for your insurance?
We are an independent agency, which means we shop for you with our 10 separate carriers, so you don't have to. Then we give you the best option out of them that provides the coverage you want and need. This is what makes us different than most agencies is that we work for you, not the carriers.
**OPTIONAL - What did your like or dislike most about your current agent/company?
"We want to know what to do or NOT to do to keep you as a customer for life"
"A few questions about your house...."
What is the address of the property you need to insure?
*
(you can manually add a Unit# after typing the main address if needed. - - -- COPY AND PASTE ADDRESS NOW INTO A NEW TAB AND GLANCE OVER AND COMPLIMENT THEM ON THEIR HOME)
City
State
Zip Code
(home details are available online (Google, Zillow,Trulia, etc)
Yes
No
Year Built
Square footage
# of Bathrooms
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6+
Swimming Pool
Yes
No
Trampoline
Yes
No
Foundation type
Slab
Crawlspace/Pier and Beam
Roof Shape - (majority of roof)
Hip
Gable
Complex or Elaborate (high value homes)
Flat
Exterior of Home and % of each
Brick Veneer
Hardiboard/Cement Fiber
Stone
Wood Siding
Vinyl Siding
Heat Source
Natural Gas
Electric
Do you know what Year the Roof was last replaced? What's your Best guess?
*
"This helps us get you the most accurate rate. If you're buying the home, this could be on the sellers disclosure or Zillow listing."
**FOR HOMES >10 YEARS OLD - - "Do you what year these systems where last updated? "
HVAC
Electrical
Plumbing
How many people will be living in your home?
1
2
3
4
5
6
7
8+
(this includes children, roommates, relatives, etc)
How long have you lived at the address above?
*
more than 2 yrs
less than 2 yrs
I'm buying it!
2nd home or rental
Current or Previous Address
*
(you can manually add a Unit# after typing the main address)
When do you need your Insurance to Start?
*
MM slash DD slash YYYY
(Effective date)
Will you have an escrow account with your mortgage company that will be paying for your homeowners insurance and property taxes?
Yes
No, I will have a mortgage but pay my own escrows
No, there is no mortgage on the home
What method of payment do you prefer to use for your home insurance?
Pay in full - E-check or Credit/Debit card
setup monthly payments using monthly EFT
Manual bill pay - mail check or online payment
"Now I need to ask a few questions about you...."
What is your Date of Birth? (mm/dd/yyyy)
*
What is your job title and industry or What kind of work do you do?
*
"Some companies use this a rating factor especially on the auto quote which we'll get to in a minute"
What is your Marital Status?
*
Single
Married
Domestic Partner
Divorced/Separated
Widowed
What is your spouse's name (or partner's) ?
First
Last
2nd Person/Spouse - Date of Birth (mm/dd/yyyy)
2nd Person/Spouse - Job Title/Industry
Coverage questions
Do you have any jewelry or firearms that exceed $1500 total?
"Most policies cover these items up to $1500 total, but they're subject to your deductible. If you have a collection of jewelry, cameras, musical instruments, fine art, firearms, or anything else of higher value there are coverages available (Scheduled Personal Property - SPP) for an additional cost that would give you extra coverage for personal property with NO deductible. "
Do you have an umbrella policy currently?
NO
YES
Want a quote
"I call this "freak accident" coverage. What would you do if you caused an accident and the person you hit was paralyzed for life? You could be on the hook for the difference between your auto liability limits and the amount of damages to that person. I like umbrella policies for 2 reasons: 1. to protect your hard earned assets and future income from wages being garnished. 2. To do the right thing. An Umbrella policy would help put that person back to square one."
Do you have any Dogs?
No
Yes
# of dogs and breeds
(restricted dogs can include: Doberman, Rottweiler, Pit Bull, Chow Chow, German Shepard. Each carrier has a slightly different list.) If someone has one of these dogs, "We may have to exclude animal liability if the dog bites or hurts someone by jumping on them so you'd need to be certain that your animal wouldn't hurt someone and you're not worried about a lawsuit because of your dog."
Do you have life insurance?
No
Yes
Height
Weight
Smoker?
No
Yes
Term or Permanent?
Email
*
"What's the best email address for us to send the proposal once we've done our research with our multiple companies?"
Phone
"Do you mind if we text you once we have the quotes completed to let you know to look at your email?"
Notes
(anything else we should know?)
Auto quote
Would you like a Quick Auto Quote too?
Yes
Not right now
"Many companies we use offer discounts anywhere from 20-30% on your home policy by bundling your auto with them. We don't want to leave money on the table and there is a VERY good chance we'll be able to save you money overall on your home/auto insurance each year." **OPTIONAL -- - "We want to help you save on your TOTAL ANNUAL insurance premiums. For example, if your home insurance is $2000/year and your auto insurance is $500/year we want to try to get your total cost down below $2500/year regardless of the cost of each policy - home vs. auto"
Drivers
First Name
Last Name
Drivers License #
Date of Birth (mm/dd/yyyy)
Relation (Self, Spouse, Child)
(only fill out the fields that we haven't already filled out above. Please input at least the first name of each person so we know who's DL# to associate with them.)
Any there any permitted drivers in the house?
NO
YES
Name and DOB of permitted Drivers:
Vehicles (click + sign to add more)
Year, Make, and Model
VIN#
(Year, Make and Model and VIN - if known)
Do you know what your current deductible is?
$250
$500
$1000 - recommended
$1500
$2000+
"Many people have a $500 deductible. If you have an emergency savings and can handle a little more out of pocket if you have an At-Fault accident, we recommend most of our clients choose the $1000 deductible. You should be able to absorb the increased $500 in deductible in about 2-3 years because of the savings each year. " ----- "" If it's a NOT-At-Fault accident you'll either have a $250 deductible in TX for your car because of the Uninsured/Underinsured coverage OR the other person's insurance will pay for your vehicle assuming they have enough"". ----- "You WILL pay less for your insurance over 10+ years of having insurance even with a claim with the $1000 deductible."
Deductible chosen/discussed?
$250
$500
$1000 - recommended
$1500
$2000+
Do you know what your current liability limits are?
State min- $30/60/25k
$50/100/50k
$100/300/100k
$250/500/100k
$300k CSL
$500k CSL
"We recommend a minimum level of coverage of $100/300/100k. What do you think it would cost to spend 2 weeks in a hospital if you had to undergo major surgery because of a car accident? It costs $10k to get a few test run in the ER so we want to make sure you're not stuck with huge bills as result of injuring someone else on the road by accident"
Liability Limits chosen/discussed?
State min- $30/60/25k
$50/100/50k
$100/300/100k
$250/500/100k
$300k CSL
$500k CSL
What company are you currently insured with?
Any moving violations for any drivers in the last 5 years?
No
Yes
"Did you get a ticket for speeding or pulled over and ticketed for anything? If you took defensive driving and it didn't show on your driving record that's always best".
Please list any details about moving violations- (approx date and violation type)
How do you currently pay for your auto insurance?
Monthly EFT
PIF - 6 months
PIF - 12 months
Monthly RCC
mail/online manual pmt
in person (NOT available)
"Our companies offer a MONTHLY EFT or PAY IN FULL option". -------(Don't offer anything else unless the client has a strong preference otherwise)
What are you currently paying monthly on your auto policy? $$
This form was completed by:
Jennifer Timble
Benjamin Yingling
John Yingling
When are you looking to finalize your Insurance?
Are you okay with us following up with you with your options via E-mail and text messages?
*
Yes
Email - YES, Text - NO
Sign up for text messages from Crawford Yingling
Sign up for text messages from Crawford Yingling
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