Personal Lines Questionnaire

Prospect Name

First Name Last Name

What lines of coverage do you currently have?

Phone

Email

Address

Street Address Address Line 2 City State ZIP Code

Who is your current agent?

How long have you been with them?

What services does your current agent provide?

Strategic planning
Account rounding
Home business coverage
Policy reviews
Online services
Custom communications (newsletter, articles, flyers, etc.)

How often do you receive communications from your agent?

How often would you want to communicate with your agent?

If you had to file a claim with your agent, how would you do so?

Do you regularly have a mid-year or pre-renewal meeting? Does your agent regularly review your policies to ensure you are both adequately covered and saving money?

Have you ever been surprised by an unexpected rate increase?

How are you prepared for a catastrophic loss? When was the last time you performed a review of the dangers to your home, family and vehicles?

Are you and your family safety-conscious?

How did you hear about First Security Company, Inc.?

This field is for validation purposes and should be left unchanged.

Tell Us A Little About Yourself.

Review your current insurance.

Let’s get started.

Personal Lines Questionnaire

Service Options

Report a Claim

Make a Policy Change

Request a Certificate

Request an Auto ID Card

Pay Your Bill

Review Your Policy

OSHA Logs

About First Security Insurance

Personal Insurance

Business Insurance

Contact Us

Hickory, NC Office

Boone, NC Office