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You are here: Home / Personal Lines Quote Request Form

Personal Lines Quote Request Form

Additional Information - Step 1 of 4
You are the applicant, unless you are completing this form on behalf of someone else.
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Other people, aside from your spouse or domestic partner might need to be a co-applicant. For example, if you have a parent or child who co-owns a house or car with you, they would need to be a co-applicant on your homeowners or auto policy.
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Describe how the co-applicant is related to the applicant.
All insurance carriers use credit scoring as part of the quoting process. By clicking Yes, you authorize Wood-Wilson Company to quote your insurance and understand that your credit score will be used in the rating process. We will not be able to offer you a quote without your
We can offer you our best pricing if you bundle your auto and homeowners insurance with us.

Auto Insurance General Information

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Most insurance companies offer a discount if the effective date of the new policy is at least seven days from the current date.
Tell us what your current bodily injury and property damage liability limits are. Most policies have split limits, which means there are separate limits for bodily injury per person and per accident and for property damage. Some policies have one limit for everything, called a combined single limit.
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When does your current policy end or renew? If you do not currently have coverage in force, please put the date your prior policy cancelled.
Our agency recommends that everyone carry at least 100,000 per personal/300,000 per accident. If you need limits that are higher than $500,000, please make note of that at the end of this quote form.
We usually recommend matching these limits to your liability limits. You may also reject this coverage entirely.
This provides coverage for injuries to you and your passengers in the event of an accident.
This is similar to personal injury protection. Most policies have either medical payments or personal injury protection.
Tell us about any auto insurance claims you have filed within the past five years. List the approximate date of loss and what happened (for example, hail damage or someone ran a red light and hit my car and took off). We will run loss history reports, and the information you provide here will help us reconcile the reports.
If you received a citation and took defensive driving or other steps to keep the citation from going on your record, you may select "no."
Tell us when and for what you or another driver received the citation(s).

Vehicle Information

Many of us enjoy driving our cars, but in this case, "pleasure" means that you don't drive your vehicle to and from work or school. "Commute" means you drive your vehicle to and from work or school three or more days per week. "Business" means you use your vehicle to conduct business, hauling stuff or driving clients around town. "Farm" means that your vehicle is kept on your farm and used in the scope of running the farm. (If you have a farm, let us quote your farm and ranch owners insurance!)
Collision provides coverage for your vehicle if you have an accident that is your fault. The deductible is how much you'll have to pay out of pocket. The higher the deductible, the lower the premium.
Comprehensive coverage, also called other than collision coverage, covers your vehicle for non-collision occurrences, such has theft, fire, hail, and vandalism.
Rental reimbursement coverage provides you with a rental vehicle if your car is disabled due to an incident coverage by your insurance policy. The first number is a daily limit, and the second number is the maximum amount of coverage available.
If you have more than four vehicles, please complete the information for the first four and note the remaining vehicle information at the end of this form.
Many of us enjoy driving our cars, but in this case, "pleasure" means that you don't drive your vehicle to and from work or school. "Commute" means you drive your vehicle to and from work or school three or more days per week. "Business" means you use your vehicle to conduct business, hauling stuff or driving clients around town. "Farm" means that your vehicle is kept on your farm and used in the scope of running the farm. (If you have a farm, let us quote your farm and ranch owners insurance!)
Collision provides coverage for your vehicle if you have an accident that is your fault. The deductible is how much you'll have to pay out of pocket. The higher the deductible, the lower the premium.
Comprehensive coverage, also called other than collision coverage, covers your vehicle for non-collision occurrences, such has theft, fire, hail, and vandalism.
Rental reimbursement coverage provides you with a rental vehicle if your car is disabled due to an incident coverage by your insurance policy. The first number is a daily limit, and the second number is the maximum amount of coverage available.
Many of us enjoy driving our cars, but in this case, "pleasure" means that you don't drive your vehicle to and from work or school. "Commute" means you drive your vehicle to and from work or school three or more days per week. "Business" means you use your vehicle to conduct business, hauling stuff or driving clients around town. "Farm" means that your vehicle is kept on your farm and used in the scope of running the farm. (If you have a farm, let us quote your farm and ranch owners insurance!)
Collision provides coverage for your vehicle if you have an accident that is your fault. The deductible is how much you'll have to pay out of pocket. The higher the deductible, the lower the premium.
Comprehensive coverage, also called other than collision coverage, covers your vehicle for non-collision occurrences, such has theft, fire, hail, and vandalism.
Rental reimbursement coverage provides you with a rental vehicle if your car is disabled due to an incident coverage by your insurance policy. The first number is a daily limit, and the second number is the maximum amount of coverage available.
Many of us enjoy driving our cars, but in this case, "pleasure" means that you don't drive your vehicle to and from work or school. "Commute" means you drive your vehicle to and from work or school three or more days per week. "Business" means you use your vehicle to conduct business, hauling stuff or driving clients around town. "Farm" means that your vehicle is kept on your farm and used in the scope of running the farm. (If you have a farm, let us quote your farm and ranch owners insurance!)
Collision provides coverage for your vehicle if you have an accident that is your fault. The deductible is how much you'll have to pay out of pocket. The higher the deductible, the lower the premium.
Comprehensive coverage, also called other than collision coverage, covers your vehicle for non-collision occurrences, such has theft, fire, hail, and vandalism.
Rental reimbursement coverage provides you with a rental vehicle if your car is disabled due to an incident coverage by your insurance policy. The first number is a daily limit, and the second number is the maximum amount of coverage available.

Driver Information

This is the total number of years you're been licensed to drive, not the number of years your current license has been in force.
This is the total number of years the co-applicant has been licensed to drive, not the number of years the current license has been in force.
If you have more than three additional drivers to add, please enter the information for the first three additional drivers here and note the additional driver information at the end of this form.
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This is the total number of years driver #1 has been licensed to drive, not the number of years the current license has been in force.
If you have more drivers than vehicles and driver #1 is not the principal operator for any vehicle, you may indicate that here. Note that by the end this application, you'll need to have assigned each vehicle to at least one principal operator so that we can give you an accurate rate quote.
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This is the total number of years driver #2 has been licensed to drive, not the number of years the current license has been in force.
If you have more drivers than vehicles and driver #2 is not the principal operator for any vehicle, you may indicate that here. Note that by the end this application, you'll need to have assigned each vehicle to at least one principal operator so that we can give you an accurate rate quote.
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This is the total number of years driver #3 has been licensed to drive, not the number of years the current license has been in force.
If you have more drivers than vehicles and driver #3 is not the principal operator for any vehicle, you may indicate that here. Note that by the end this application, you'll need to have assigned each vehicle to at least one principal operator so that we can give you an accurate rate quote.

Homeowners Insurance General Information

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Most insurance companies offer a discount if the effective date of the new policy is at least seven days from the current date.
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Information About Your Home

Examples: brick veneer, wood siding, vinyl siding, fiber cement (Hardie plank) siding, stucco, EIFS.
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Living area only; do not include the garage.
Examples: asphalt shingles, architectural shingles, tile, wood shakes, standing seam metal
If the year of roof replacement is the same as the year your home was built, please enter that year here.
We like animals! Tell us about your dogs. How many do you have? What breed of dog(s)? Have they ever been naughty and bitten anyone?
A monitored alarm system is one monitored by a third-party company, like ADT, or the police.
Tell us about any smart features you have in your home, such as front door cameras, smart water heater leak detectors, smart smoke alarms, etc.
Tell us about any renovations that have been done to your home. We'd like to know what you did and when. For older homes, we'd like to know what updates to the heating, plumbing and electrical systems have been made.
Please tell us about any special features of your home that we haven't already asked about. Special features include specialty rooms, such as a media room/home theater; a fence with gate surrounding the house; 24-hour community security patrol and/or a gated community; protection systems such as lightning protection or a water flow alarm. Be sure to include as many details as you can.
Tell us about any homeowners insurance claims you have filed within the past seven years. List the approximate date of loss and what happened (for example, hail damage to the roof or water heater leak). Also please indicate whether or not the damage to your home has been repaired. We will run loss history reports, and the information you provide here will help us reconcile the reports.

Homeowners Insurance Coverages

If this home is a new purchase, please input the purchase price here.
If this home/condo is a new purchase, please input the purchase price here.
Most carriers require a 1% minimum wind/hail deductible.
Most carriers require $1,000 minimum but 1% is the most common deductible.
An umbrella or excess liability policy provides additional liability coverage. It sits over your auto liability and homeowners liability, covering you like a regular umbrella covers you during a rainstorm! We'll provide you with a quote for $1 million based on your auto and homeowners information. When we discuss our proposal with you, we will discuss tailoring the coverage to your specific needs.
We can insure any valuable and/or collectible items you have on a valuable articles schedule. If you have any items you'd like to schedule, please list the items here, including a description and value.
Guess what? We can insure these too!
Do you have anything to add? If you have additional vehicle and/or driver information, please enter it here.

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Wood-Wilson Co., Inc. strives to serve the insurance and risk management needs of our clients with a level of service at the highest possible standards. Continue Reading

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Wood-Wilson Company, Inc.
8131 LBJ Freeway Suite 220
Dallas, TX 75251
(972)783-4915
woodwils@woodwilson.com

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