- Designed specifically for Chubb clients
Your lifestyle, assets, and exposures can change over time. This brief review will help
us identify changes that may affect your insurance program, uncover potential coverage
gaps, and identify opportunities to enhance your protection.
If you own more than one home: Please consider all of your homes as you complete
this questionnaire. When you answer “Yes” to a question that applies to a specific
home, please identify the property and provide the requested information for each home
to which the answer applies.
Ready to begin?
Select Your Review Sections
Please select the sections to include in this review. (Select all that apply) *
- Only the selected sections will appear in the questionnaire.
Contact Information
What is your first name? *
What is your last name? *
What is your phone number?
What is your email address?
Homes and Property
Have there been any significant changes or improvements to your home(s) in the last 12 months?
- Examples might include installing solar panels, geothermal systems, adding a generator, converting to natural gas, installing an EV charging system, adding an elevator, making significant landscaping or exterior improvements, or other changes that could affect the property or how it is insured.
Please describe the change or improvement. If you own more than one home, please identify the property associated with each change.
Have you completed, started, or planned any renovations or major constructions projects in the last 12 months?
- Examples might include a new roof, kitchen or bathroom renovation, addition, structural work, or significant updates to electrical, plumbing, heating, windows, or doors.
Please identify the property, if you own more than one home, and briefly describe the project(s), including the approximate scope of work, budget, and anticipated or actual completion date.
Has the occupancy or use of your home(s) changed in the last 12 months?
- For example, a home becoming a primary residence, secondary or seasonal residence, rental property, short-term rental, vacant or unoccupied property, or a property undergoing extended construction.
Please identify the property, if you own more than one home, and describe the change in occupancy or use.
Have you started operating a business from your home(s) or significantly changed an existing home-based business in the last 12 months?
Please identify the property, if applicable, and briefly describe the business or change.
Has the ownership of your home(s) changed in the last 12 months, including ownership by a trust, LLC, or other legal entity?
Please identify the property and briefly describe the ownership change.
Have you installed or upgraded any home protection or loss-prevention systems in the last 12 months?
- Examples may included centrally monitored fire or burglar alarms, water leak detection, automatic water shutoff systems, permanently installed backup generators, low-temperature monitoring, video surveillance, lightning protection, electrical or fire monitoring, hurricane protection, or other loss-prevention systems.
Please identify the property, if you own more than one home, and describe the system(s) installed or upgraded. Please include the monitoring or alarm company, if applicable.
Flood Protection
Would you like to review your options to add or expand flood insurance protection for damage caused by storm surge, heavy rain, or other ground-level flooding?
Please provide any questions or concerns you have about flood protection. If your question relates to a particular home, please identify the property.
Cyber Protection
Would you like to learn more about, further discuss, or review opportunities to expand your personal cyber protection?
- Personal cyber coverage can provide protection for exposures such as wire transfer fraud, data breaches, cyber extortion or ransomware, online fraud, cyberbullying, and other cyber-related risks.
Please let us know if there is anything specific you would like to discuss regarding cyber protection.
Jewelry, Fine Art & Valuable Collections
Have you acquired any significant jewelry, fine art, wine, collectibles, antiques, or other valuable items in the last 12 months?
Please briefly describe the item(s) you acquired.
Do you have any appraisals that are more than three years old that may need to be updated for significant scheduled valuable items?
Please briefly describe the item(s) that may need an updated appraisal.
Is any of your fine art currently in any of the following situations? (Select all that apply)
Please provide additional information regarding the artwork and its current location, use, transportation, or storage arrangements.
Have you changed how or where any significant valuables are stored in the last 12 months?
- For example, moving valuables to or from a home safe, bank vault or safe-deposit facility, specialized storage facility, or another home.
Please briefly describe the change in storage arrangements.
Vehicles & Drivers
Have you purchased, leased, ordered, sold, or traded any vehicles in the last 12 months?
Please briefly identify the vehicle(s) and indicate whether each was purchased, leased, ordered, sold, or traded.
Are there any new drives in the household?
Please provide the name, date of birth, occupation, and driver's license number for each new driver.
Do you have any children attending school away from home?
Please provide the student's name and school name.
Has the use of any of your vehicles changed significantly in the last 12 months?
- Examples may include using a vehicle for business, rideshare or delivery services, a significant change in annual mileage, or keeping a vehicle at a different residence or in another state.
Please identify the vehicle and briefly describe the change in use.
Have you paid off a vehicle loan or changed the financing or any vehicle in the last 12 months?
Please identify the vehicle(s).
Liability & Personal Umbrella
Has your net worth changed significantly in the last 12 moths?
Please provide any information you would like us to consider as part of your liability coverage review.
Do any of the following currently apply to you or your household? (Select all that apply)
Please describe any other activities or exposures you would like us to be aware of.
Household & Lifestyle
Has anyone moved into or out of your household in the last 12 months?
Please briefly describe the change.
Have any of the following significant life events occurred in the last 12 months or are expected in the coming year?
Please briefly describe the event(s) and anything you would like us to review.
Household Employees
Do you currently employ household workers?
- The may include a nanny, housekeeper, caretaker, personal assistant, driver, chef, estate manager, or other domestic employee.
Have there been any significant changes to your household staff in the last 12 months?
- For example, hiring or terminating an employee or significant changes to an employee's duties, hours, responsibilities, or compensation.
Please briefly describe the change(s).
Would you like to learn more about protection related to employment-related allegations involving household employees?
- This may include allegations involving wrongful termination, discrimination, harassment, or other employment practices.
Travel
Do you or members of your household travel frequently domestically or internationally?
Would you like to learned more about or discuss protection and services that may be available for medical emergencies, evacuation, security assistance ,or other travel-related risks?
Risk Management Services
Which risk-management or loss-prevention services would you like more information about?
Chubb Client Services & Resources
- As a Chubb client, you may be eligible for additional services and resources designed to help protect you, your family, and your property.
Please indicate which services you already use and which you would like to learn more about by selecting the appropriate check boxes below.
Aura - Personal Cyber Security
Chubb SafeLane - Safe Driving Program
Chubb Mobile App
Ting - Electrical Fire Prevention
Review Thoughts
Is there anything else that has changed in the last 12 months, or anything you are concerned about, that you would like to discuss?
