The Covered team is excited to help find your perfect insurance policy!

The following questions help Covered's fantastic licensed insurance agents get you home and auto quotes from several of the best carriers. Answer as many as you can, though it's ok if you're unsure and need to leave some questions unanswered. Submit the form and we'll get back to you quickly with quotes and any follow-up questions. Cheers!
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Would you like a home insurance quote? *

     
 
Would you like an auto insurance quote? *

     
 
When do you want your new policy to be effective? *

 
What's your full name? *

 
What is your address? *

Street, City, State, Zip Code.
The address of the property you'd like quoted for home insurance, or your current address for only an auto insurance quote.
 
Do you own or rent this home? *


 
What's your phone number? *

 
What's your birthday? *

 
What's your marital status? *


 
What's your education level?


 
What is your occupation?

 
Do you currently have property insurance?

     
 
Do you live in this home?


 
What Type of home is it?


 
When did you purchase the home?

 
How may bedrooms are in the home?

 
How many bathrooms are in the home?

 
What is the approximate living area square footage?

Please include your basement if applicable.
 
How many stories does your home have?

Don't include basements here.
 
What is the roofing material?

Asphalt Shingles are the most common.

 
Is there a garage?


 
How big is the garage?


 
Is the property on a slope?

     
 
Does your home have central air conditioning?

     
 
What is the primary source of heat?


 
When was your home last renovated?

If your home has been updated since it was built, you may receive a lower rate. If you don't know, just write "I don't know."
 
Plumbing improvement year

 
Roofing improvement year

 
Wiring improvement year

 
Heating improvement year

 
What is the Construction type?

Most homes are Wood Frame with Siding. Most brick and stone homes built after 1920 are Masonry over Wood Frame.

 
What's the foundation type?


 
What's the average ceiling height in your home?

Answer in feet (eg. 9 ft).
 
Does your home have 60 feet or more of Fence?

     
 
What is the distance to the nearest fire station?

Answer in miles. If you don't know, simply write "I don't know"
 
What is the distance to the nearest fire hydrant?

Answer in feet (ex: 500 ft) or miles (ex: 2 miles) depending on your situation. A typical city block is 900x300 ft. If you don't know, simply write "I don't know"
 
Do you have a home alarm system?

     
 
What type of system is it?


 
What is the fire alarm type?


 
Is there a fire suppressing sprinkler system?


 
How many People Live in the household?

 
Do you conduct business on the premises?

     
 
What type of business is it?


 
Approximately how many customers visit your business each Week?

 
Do you have a mortgage?


 
Please provide information about your mortgage co-signers:

Provide their name, address, and loan number exactly as it needs to appear on your policy.
 
The next section is about coverage limits and deductibles.

Covered recommends purchasing coverage above the minimums because for a slightly higher premium you can greatly reduce your risk. Think about how much you're comfortable with contributing when choosing deductibles. Also keep in mind that making claims for small incidents will likely increase your premiums in the future.

 
Desired property deductible:

This is the dollar amount you're responsible for paying in the event of a covered loss; the claim payment is reduced by the deductible amount. Higher deductibles generate a premium reduction as the insured is essentially retaining more of the risk, but it's very important to consider what you can really afford to pay out of pocket in the event of a loss.

 
Desired personal liability coverage:

This is the limit of insurance available for claims arising out of bodily injury and/or property damage for which the insured is legally liable due their negligence.

 
Desired wind & hail deductible:

A separate deductible for claims caused by wind or hail.

 
Desired personal umbrella coverage:

An umbrella is additional liability coverage that extends to all your belongings and everyone in your family. Purchase a coverage amount that matches the value of assets you would want to protect if you were to get sued. Umbrella coverage is especially helpful for families with young drivers or additional liabilities such as boats or swimming pools.

 
Would you like flood coverage?

Standard homeowner insurance policies DO NOT include ANY flood insurance. If your home is in an area that may flood, we recommend purchasing this additional coverage.
     
 
Would you like mold coverage?

     
 
Would you like building ordinance update compliance increased cost coverage?

If your home needs to be repaired, it will need to be brought up to code. This coverage takes care of additional costs associated with making sure everything is done properly. Example: If you have an older home and a fire destroys a bedroom, when it is repaired the wiring will need to be brought up to code. The wiring repairs could extend beyond the bedroom, so this coverage will help pay to make sure the wiring is all fixed correctly.
     
 
Would you like to purchase additional coverage for high-value items?

This is additional coverage beyond contents replacement for specific high-value items. We recommend getting this for anything worth more than $1,000.
     
 
Please list items you'd like additional coverage for along with their value:

Jewelry, guns, electronics, art, instruments, etc.
 
Would you like sewer & drain backup coverage?

Damage from backed up drains and pipes in your home are not covered by most policies unless you add this coverage.
     
 
What is your vehicle identification number? (VIN)

Your vehicle identification number can be found in behind the windshield on the driver's side of the dashboard. It contains 17 letters and numbers. It's ok if you don't know, just write "not sure".
 
Vehicle Year?

In what year was your automobile manufactured
 
Vehicle Make?

(eg. Chevrolet, Jeep, Toyota, Mercedes, etc.)
 
Vehicle Model?

(eg. Camry, Wrangler, F150, etc.)
 
Vehicle Ownership Status?


 
Name of lease or lending company?

Who has the title to your vehicle?
 
What is your loan or lease number?

 
How do you use this vehicle?

What is your primary use of this vehicle? Typically this is pleasure, unless you only use it for commuting or business.

 
The next section is about the primary driver of your vehicle.

 
Driver's License State

 
Driver's License Number

 
Has the driver been required to file an SR22 in the past 5 years?

This is not common. An SR-22 is a vehicle liability insurance document required by most state Department of Motor Vehicles (DMV) offices for "high-risk" insurance policies such as drivers who have lost their license or been convicted of a DUI.
     
 
The next section is about the primary driver's driving history.

 
How old was the driver when they first got their license?

 
Is this vehicle or another vehicle of yours currently insured?

     
 
The next section is about the coverages you'd like for your new auto insurance policy.

 
Desired Bodily Injury Liability:

This is the limit of insurance available for claims arising from physical injury to a person, including sickness or disease, for which the insured is legally liable due their negligence. This coverage is required in most states and is purchased as separate limits for bodily injury per person/ bodily injury per accident (total per person/total per accident).

 
Desired Property Damage Liability:

This is the limit of insurance available for claims arising out physical damage to property of others caused by negligence of the insured.

 
Desired Medical Payments or Personal Injury Protection

This is the limit of insurance available for claims arising from bodily injury to the insured or passengers of the insured vehicle, regardless of fault. Provides coverage for medical and funeral expenses, up to the limit listed on the policy. Can also provide coverage for injuries sustained by the insured while a passenger in someone else's car and when struck by a vehicle when walking or cycling. Limit of insurance applies per injured person.

 
Desired Collision Deductible:

Optional insurance coverage for damages to vehicles resulting from a collision with other vehicles or due to overturn of the vehicle.

 
Desired Comprehensive Deductible:

Optional insurance coverage for damages to vehicles resulting from several events other than collision. Comprehensive insurance provides coverage for damages to the insured vehicle resulting from theft, vandalism, damage from hitting animals, fire, falling objects, glass damage and natural disasters such as flood, wind and hail.

 
Desired rental car reimbursement coverage:

This will provide you a stipend towards a rental car if your car is unable to be used due to a covered Claim such as theft or an accident.

 
Would you like to add another vehicle to your quote?

     
 
What is your vehicle identification number? (VIN)

Your vehicle identification number can be found in behind the windshield on the driver's side of the dashboard. It contains 17 letters and numbers. It's ok if you don't know, just write "not sure".
 
Vehicle Year?

In what year was your automobile manufactured
 
Vehicle Make?

(eg. Chevrolet, Jeep, Toyota, Mercedes, etc.)
 
Vehicle Model?

(eg. Camry, Wrangler, F150, etc.)
 
Vehicle Ownership Status?


 
How do you use this vehicle?

What is your primary use of this vehicle? Typically this is pleasure, unless you only use it for commuting or business.

 
Vehicle Ownership Status?


 
Name of lease or lending company?

Who has the title to your vehicle?
 
What is your loan or lease number?

 
Is someone other than the primary insured going to drive this vehicle?

Add a second driver. This could include a husband, wife, child, or other person who regularly drives the vehicle.
     
 
What is the Additional Driver's name?

 
What is {{answer_55964912}}'s birth date?

 
What is {{answer_55964912}}'s Driver's License Number?

 
{{answer_55964912}}'s Driver's License State:

 
Has {{answer_55964912}}been required to file an SR22 in the past 5 years?

This is not common. An SR-22 is a vehicle liability insurance document required by most state Department of Motor Vehicles (DMV) offices for "high-risk" insurance policies such as drivers who have lost their license or been convicted of a DUI.
     
 
Have you had any insurance claims or losses in the past 5 years? *

     
 
I certify that the information provided is accurate. I acknowledge that in order to provide accurate rates, Covered must obtain data from third parties including information about driving records, credit history, and insurance claims history. By selecting this checkbox, I grant Covered and its carrier partners permission to access these reports. *

     
Thank you! The Covered team will be in touch with you shortly.

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