Excess Flood Renewal Risk Evaluation

This form will assist you with assessing excess flood insurance renewal information.

Insured Type?

Is the insured for this excess flood renewal an individual or legal entity?

Individual
Legal Entity (ie. LLC, Corporation, etc.)

Insured 1 First Name

Enter the insured's first name.

Insured 1 Last Name

Enter the insured's last name.

Legal Entity Name?

Enter the name of the legal entity.

Insured's Phone Number

Enter the insured's phone number.

Insured 1 Email

Enter the insured's email.

Property Address

Enter the address of the risk location for this excess flood renewal.

Street Address Address Line 2 City State ZIP Code

Residential or Commercial?

Select the property type for this excess flood renewal.

Residential
Commercial

Dwelling Current Replacement Cost?

Enter the building's current replacement cost.

Current Policy Information

Excess Flood Expiration Date

Enter the current expiration date.

Current Excess Flood Dwelling Limit

Enter the current excess flood dwelling coverage limit.

Current Excess Flood Personal Property Limit

Enter the current excess flood personal property coverage limit.

Dwelling Current Price

Enter the current price for excess flood dwelling coverage.

Personal Property Current Price

Enter the current price for excess flood personal property coverage.

Expiring Policy Taxes and Fees

Enter the expiring policy taxes and fees amount.

Expiring Excess Flood Policy Price

Total expiring premium (Calculates automatically from above figures)

Renewal Quote Information

Renewal Excess Flood Dwelling Limit

Enter the renewal excess flood dwelling coverage limit.

Renewal Excess Flood Personal Property Limit

Enter the renewal excess flood personal property coverage limit.

Dwelling Renewal Quote

Enter the renewal quote for excess flood dwelling coverage.

Personal Property Renewal Quote

Enter the renewal quote for excess flood personal property coverage.

Estimated Taxes and Fees

Enter the estimated taxes and fees for this renewal quote.

Total Renewal Excess Flood Quote

Total quote for this excess flood renewal, including taxes and fees. (Calculates automatically when all previous quote fields are populated.)

Property Risk Profile

Property Flood Zone

Select the flood zone the renewal pricing is based on.

Feet to the Coast/Water

Enter distance to the coast/water in feet.

Elevation Certificate on File?

Is there an elevation certificate on file?

Yes
No

Upload Elevation Certificate

Upload a copy of the elevation certificate.

Max. file size: 128 MB.

Property Elevation

What is the property elevation? (Enter if available)

Excess Flood Risk Mitigation

Select the risk mitigation currently in place at this property. (Select all that apply)

Flood vents
Breakaway walls
Flood barrier/wall

Other Structures

Select the other structures / outbuildings on this property that may have flood risk as well.

Detached garage
Shed
Dock
Pier
Boat house
None

Quote Scenario Center

Excess Flood Renewal Price Difference

Premium difference from the expiring policy to the renewal quote. (Automatically calculates when appropriate fields are populated.)

Excess Flood Coverage Underinsurance

Below is the gap in coverage if the policy is renewed with the renewal dwelling limit listed above. (Calculates automatically)

Suggested Coverage to be Insured to Value

Below is the recommended excess flood coverage limit to ensure the dwelling is insured to value. (Calculates automatically)

Scenario Dwelling Coverage Limit

Enter the desired dwelling coverage limit for this scenario.

Excess Flood Dwelling Coverage Rate

Excess flood dwelling coverage rate per hundred dollars of coverage. (Calculates automatically when appropriate fields are populated.)

Scenario Dwelling Coverage Quote

Quote estimate for excess flood dwelling coverage. (Calculates automatically when desired limit is entered above.)

Scenario Personal Property Coverage Limit

Enter the desired personal property coverage limit for this scenario.

Excess Flood Personal Property Coverage Rate

Excess flood personal property coverage rate per hundred dollars of coverage. (Calculates automatically when appropriate fields are populated.)

Scenario Personal Property Coverage Quote

Estimated quote for personal property coverage. (Calculates automatically when desired personal property limit is entered above.)

Estimated Scenario Taxes and Fees

Enter the estimated taxes and fees amount for this scenario.

Estimated Total Scenario Quote

Estimated total dwelling and personal property coverage quote. (Calculates automatically if previous fields in the scenario section are completed.)

Alternate Limit Quote Request

Would you like us to quote the above scenario for you?

Yes
No

Documents and Comments

Document uploads

Please use this field to upload any relevant insurance documents.

Drop files here or

Max. file size: 128 MB.

Please enter any additional remarks in the space below.

Consent*

Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.

Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes.

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Excess Flood Renewal Risk Evaluation

Current Policy Information

Renewal Quote Information

Property Risk Profile

Quote Scenario Center

Documents and Comments

Alice Romeo

RiskRevu^TM Newsletter

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Excess Flood Renewal Risk Evaluation

Current Policy Information

Renewal Quote Information

Property Risk Profile

Quote Scenario Center

Documents and Comments

Alice Romeo

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RiskRevuTM Newsletter

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RiskRevu^TM Newsletter