SaveMillions - Homeowner's Insurance Worksheet

 

Information to give agents or insurance companies

 

Address of property to be insured:                   ____________________________________

Number of losses in past three years:                  ____________________________________

Description of dwelling:

      Number of apartments or households in building         ______________________________

      Construction materials (frame, brick, etc.)                 ______________________________

      Number of stories                                                    ______________________________

      Number of rooms                                                     ______________________________

      Total square feet                                                      ______________________________

      Age of dwelling                                                        ______________________________

      Age of roof                                                              ______________________________

      Age/type of furnace                                                  ______________________________

      Number of smoke detectors                                     ______________________________

      Security devices                                                      ______________________________

      Owner occupant?                                                     ______________________________

      Inside city limits?                                                     ______________________________

      Name of fire department                                           ______________________________

      Distance from fire hydrant/fire station                         ______________________________

      Business in the home?                                             ______________________________

Current dwelling replacement cost                                   ______________________________

Current market value of dwelling and land                         ______________________________

Purchase price of dwelling                                              ______________________________

Property coverage:

      Dwelling (100% of replacement cost)                          ______________________________

      Other structures (detached garage, shed, fence)         ______________________________

      Personal property (contents of home)                         ______________________________

      Living expense (usually 20% of dwelling coverage)       ______________________________

Deductible for property coverage:                              

$500 or $1,000 (the higher, the less your premium)     ______________________________

Liability coverage:

      Personal liability (bodily injury and property damage)   ______________________________

      Medical payments to others                                      ______________________________

Riders:

      Business activities                                                   ______________________________

      Earthquake                                                             ______________________________

      Flood                                                                      ______________________________

      Scheduled property (computer, jewelry, etc.)               ______________________________

      Secondary resident (vacation home)                          ______________________________

      Windstorm (not included in some coastal areas)         ______________________________


 

Information to get from agents or insurance companies

 

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Insurance company name                                   __________       __________       __________      

Policy form (perils included)                                __________       __________       __________      

Coverage exclusions                                          __________       __________       __________      

Inflation guard included?                                     __________       __________       __________      

Discounts available:

            Auto policy with same insurer                 __________       __________       __________      

            New home/renovation                             __________       __________       __________      

            Nonsmoker                                            __________       __________       __________      

            Renewal/longtime policyholder                __________       __________       __________      

            Security devices                                    __________       __________       __________      

            Senior citizen                                        __________       __________       __________      

            Smoke detectors/fire extinguishers          __________       __________       __________      

            Fire-retardant roof                                   __________       __________       __________      

            Storm shutters                                       __________       __________       __________      

            Other                                                    __________       __________       __________      

Annual premium:                                             __________       __________       __________

Installment charges (if applicable):                    __________       __________       __________