Client Intake Form

This covers costs associated with injuries and death that you or another driver causes while driving your car. This coverage will reimburse others for damage that you or another driver operating your car causes to another vehicle or other property, such as a fence, building or utility pole.

Reimburses you when an accident is caused by an uninsured motorist—or in the case of a hit-and-run. You can also purchase under insured motorist coverage, which will cover costs when another driver lacks adequate coverage to pay the costs of a serious accident.

This optional coverage reimburses you for damage to your car that occurs as a result of a collision with another vehicle or other object—e.g., a tree or guardrail—when you’re at fault. While collision coverage will not reimburse you for mechanical failure or normal wear-and-tear on your car, it will cover damage from potholes or from rolling your car.

This provides coverage against theft and damage caused by an incident other than a collision, such as fire, flood, vandalism, hail, falling rocks or trees and other hazards—even getting hit by an asteroid!

Provides reimbursement for medical expenses for injuries to you or your passengers. PIP will also cover lost wages and other related expenses.

This coverage pays for a rental car if your vehicle is damaged and undriveable due to a covered loss. This coverage does NOT pay for a rental car when your vehicle is being repaired for any other reason.