Policy Change - Karweik Insurance Group

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Policy Changegld_ins2020-01-27T20:17:04+00:00

Which Policy Do You Need To Service?*
- Auto Policy
- Home Policy

Please Select The Home Changes You Need To Make*
- Change Mortgage Company
- Add More Personal Property Coveage
- Change Your Mailing Address
- Other

New Mortgage Company*
Mortage Company Name and Street Address Loan Number City State ZIP Code

Please Specify The Items Needing Coverage And Their Individual Values

New Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Specify Your "Other" Changes. Be As Specific As Possible*

Please Select The Changes You Need To Make*
- Add Or Replace A Car
- Remove A Car
- Add A Driver
- Remove A Driver
- Add A Lienholder
- Change Your Mailing Address
- Other

Your Name*
First Last

Which Car Are You Removing? (Yr, Make, Model)*

Reason For Removal?*
- Sold
- Non-Opt

When Did You Get Rid Of The Car? (Specific Date)*

New Driver Full Name*

New Driver Date Of Birth*

New Driver DL#*

New Driver Relation To You*

New Driver's Employer or School*

Current High School Student With A 3.0 or Better GPA?*
- Yes
- No
If the new driver is a high school student with a 3.0 or better GPA, they will qualify for a "good student discount". You will need to submit proof (last report card) to support@thrivesure.com

Name Of Driver You Are Removing?*

Is This Person Still A Household Resident?*
- Yes
- No

Bank Name*

Which Vehicle Is This For?*

New Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Specify Your "Other" Changes. Be As Specific As Possible*

Is This New Car Replacing Another Car?*
- Yes (Replace A Current Car With A Different Car)
- No (This Is New Car To Me)

Which Of Your Vehicles Are Re Replacing With The New Car? (Yr/Make Model?*

How Will The New Car Be Used?*
- Pleasure
- Work/School Commute
- Business/Commercial

How Many Miles Will This Car Be Driven Annually?*
The CA DMV says the average commuter will drive approximately 13,000 miles a year.

What Is The 17 Character VIN# Of Your New Car?*
Please double check your entry to make sure it's correct.

What Is The Odometer Of Your New Car?*

What Was The Purchase Date?*

Does Your New Car Need "Full Coverage"?*
- Yes
- No

What Comprehensive Deductible Would You Like?*
- $100
- $250
- $500
- $1000
Comprehensive covers everything other than an at fault accident. Ex. Theft, vandalism, a rock cracking your windshield on the freeway, etc.

What Collision Deductible Would You Like?*
- $100
- $250
- $500
- $1000
NOTE: The lower the deductible, the higher the premium.

Is There A Lien Holder? If So, Who?*
If none, enter "none"

Who Is The Primary Driver?*
If none, enter "none"

Mobile Number*
We Will Send A Text Confirmation That This Request Was Received

Email

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