Personal Insurance Moving Risk Evaluation

Insure Your Move

Please help us ensure your personal property is properly covered when it is being transported from one location to another.

What is your first name? **

What is your first name? *

What is your last name? **

What is your last name? *

What is your email address? **

What is your email address? *

What date will your personal property be packed and shipped? (Approximate)

What date will it be installed at its new location? (Approximate)

What is the value of all the personal property you will be transporting in this move? (Approximate)

Please select the types of high value property you will be transporting during your move.

Please select the types of high value property you will be transporting during your move. (Select all that apply)

What other type of valuable property will you be transporting?

What is the approximate value of the jewelry being transported?

Please select the security measures that will be utilized to protect your jewelry when in transit.

Items transported in unmarked cases
Private security
Sent via private aircraft
None

What is the approximate value of the fine art being transported?

What is the approximate value of the wine/spirits collection being transported?

What is the approximate value of the stamps/coins collection being transported?

What is the approximate value of the firearms collection being transported?

What is the approximate value of the silverware/goldware/metalware collection being transported?

What is the approximate value of the watercraft being transported?

What is the approximate value of the fragile articles being transported?

Do you have a valuable articles policy in place to cover high value property while it is in transit?

Yes
No
Not sure

Will you be transporting any property that you do not own?

Yes
No
Not sure

What is the approximate value of the non-owned property being transported?

Does the owner of the non-owned property you are transporting have coverage for their property?

Yes
No
Not sure

Will any of your personal property be placed into a storage facility as part of this move?

Yes
No
Not sure

What is the name of the storage facility?

What is the address of the storage facility?

Street Address Address Line 2 City State ZIP Code

Coverage Considerations

The following questions are designed to alert you to coverage areas that should be reviewed prior to transporting personal property.

Is your personal property coverage limit adequate to cover a total loss during this move?

Yes
No
Not sure

Is your deductible acceptable for this move?

Yes
No
Not sure

Did you confirm that you have replacement cost coverage for your personal property while it is in transit?

Yes
No

Will you be staging a residence you are selling with rented furniture and other decorative property as part of this move?

Yes
No
Not sure

Disclaimer: This form is designed to assist with identifying some of the exposures to risk during a move. Some exposures may not be included in this question set.

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.

I agree *

Personal Insurance Moving Risk Evaluation

Insure Your Move

Coverage Considerations

Brian Cook

RiskRevu^TM Newsletter

Contact

Personal Insurance Moving Risk Evaluation

Insure Your Move

Coverage Considerations

Brian Cook

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RiskRevuTM Newsletter

Contact

RiskRevu^TM Newsletter