Commercial Insurance Renewal

Company Name:
Policy Number:
Your Name:

Are you authorized by the business above to complete the following insurance review?

This form may only be completed by an authorized personnel. Please redirect this e-mail to the appropriate individual.

1. Has there been any changes to your business's operating name, physical or mailing address, product or service offerings, business entities or partnerships?

Please explain:

2. After reviewing your insurance renewal, can you confirm that the current coverage limits such as building limits, commercial equipment values, and contents limits are appropriate for your needs if you experience a major loss?

Please explain:

3. In the event that your business is faced with a lawsuit, do the included liability limits seem appropriate for your business's level of assets as well as liability exposure?

Please explain:

4. Please confirm if you require either changes to the following coverages, or the addition of these coverages if you have not previously purchased them:
Business contents (computers and accessories, furniture, miscellaneous supplies) YesNo
Tools or equipment (hand held tools, power tools, specialized machinery etc.) YesNo
Cyber breach (liability and recovery expenses due to confidential data leaks) YesNo
Professional error (liability due to faulty advertisement or professional negligence) YesNo

5. Have there been any other recent changes to your business that may influence your insurance needs?

Please explain:

In-Person Policy Review Request
Yes PleaseNo Thanks

Are you sure? Declining regular insurance reviews can impact the results of future claims if you are found to be incorrectly insured.
On second thought, let's do it!I'm sure.
Company Name:
Contact Person:
Contact Number:

Preferred Review...
Date:
Time:
Location: HGA Insurance OfficeOther

Where?