Auto Insurance Quote Request

For the fastest and most accurate automobile insurance quote, please provide as much information as possible in the form below. This information will be kept confidential and will be used for quote purposes only. Please Read Our Online Privacy Policies

General Information:
Applicant: *
Email: *
Street Address:
City: State:   ZIP:
Phone : Home: Other:

Driver Information:
Driver's Name Marital Status Lic. # Lic. State
Date of birth
1.
2.
3.
4.
5.

Vehicle Information:

Please include all cars you or your family members own

Year- Make - Model Vehicle ID# (VIN) Main Driver Usage
1.
2.
3.
4.
5.

Accidents or Violations in Past 5 Years :
Incident Dates and Descriptions
1.
2.
3.

Additional Information:
Current Insurance Company:
Current Policy Length:
Employer:
Occupation:
Years at Current Employment:
Drivers Under 21 Qualifying As Good Student:
Drivers Under 21 Qualifying For Driver Training:

Coverage Information:
Liability Coverage- Bodily Injury:
Property Damages:
Uninsured Motorist Coverages:
Medical Payments:
Comprehensive Coverage:
Collision Coverage:
Towing Coverage:
Rental Reimbursement:
Additional Comments:
* Required
     

239 Main Street

Danielson, CT 06239

Phone: (860) 774-1389

Text:     (860) 821-0774

Tap to Call

email: macdins@snet.net



What We Do

Personal Coverage

  • homeowners
  • automobile
  • umbrella liability
  • boats/yachts
  • fine arts
  • motorcycles
  • condo
  • tenants
  • mobile homes
  • motor home
  • flood
  • classic car

 

Business Coverage

  • package policies
  • workmens compensation
  • business automobile
  • general liability
  • property
  • inland marine
  • crime
  • bonds

 

Financial Planning

  • life insurance
  • disability plans
  • IRA
  • pensions
  • individual health insurance
  • group medical insurance
  • annuity