KIA Personal Insurance Checklist

KIA Insurance can often save our clients on all types of insurance. We are eager to offer you a quotation to prove it. Click here to go to our Quotations Page where we let you choose what insurance products you want to shop for. Please first fill in the checklist below to let us help make sure you have the right kind of insurance coverage.

Please fill out and click SUBMIT FORM at bottom of page
All fields require an entry to process.

Personal Information
Name
Address
Suite or Apt.
City
State
Zip Code
Home phone
Work phone
Cell phone or Pager
E-Mail Address
Information about property
Yes No	Do you have collectibles such as antiques, fine art, stamps, etc.?
Yes No	Do you own valuable jewelry or furs?
Yes No	Do you own costly sporting equipment or firearms?
Yes No	Do you have valuable cameras or photographic equipment?
Yes No	Do you have any alarms installed?
	What type of alarm?
Yes No	Alarm connected to the central station monitoring?
Yes No	Do you keep more than $100 cash in your home?
Yes No	Are your personal belongings insured for their full replacement value?
Yes No	Do you have children away in college?
Yes No	Are their possessions insured?
Yes No	Do you own tools, equipment or instruments used in you trade or profession?
Yes No	Do you operate an office or studio in your home?
Yes No	Do clients come into your home to make purchases?
Yes No	Do you baby-sit in your home?
Yes No	Have you recently remodeled or redecorated your home?
Yes No	Do you plan on doing so soon?
Yes No	Is your home insured for its full replacement value?
Yes No	Are you interested in flood insurance for your home and personal property?
Yes No	Are you interested in earthquake insurance?
Yes No	Do you use a wood-burning stove?
Yes No	Do you have a swimming pool?
Yes No	Do you own rental or investment property?
Yes No	Do you own a vacation home?
Yes No	If you rent, do you carry renter's insurance?
Yes No	Do you plan to purchase a new car this year?
Yes No	If you are already a client, do we insure all of your vehicles?
Yes No	Does your auto policy specify all of the drivers in your household by name?
Yes No	Do you routinely use vehicles you do not own?
Yes No	Do you have non-factory installed equipment in you automobile such as car phones, stereos, etc.?
Yes No	Do you store CDs or cassette tapes in your car?
Yes No	Do you have a vehicle with customizations or conversions?
Yes No	Do you have auto rental coverage if you are in an accident>
Boat Camper All-terrain vehicle Motor Home Golf cart Moped Motorcycle Snowmobile Other	Do you own any of these vehicles?
Yes No	Do you carry an umbrella liability policy for at least $1 million?
Yes No	Do you own a business?
Yes No	If so, do we insure it?
Yes No	Do you plan to start a business?
Yes No	May we review your life insurance needs with regard to that business and "key-person" coverage?
Yes No	Do you have sufficient professional liability or malpractice coverage?
Yes No	Do you and your family have proper health insurance coverage?
Yes No	Do you have disability income insurance?
Yes No	Do other family members need such coverage?
Yes No	May we review your personal life insurance needs?
Yes No	Do you have life insurance that pays your mortgage in case of your death?

Comments, if necessary