Auto insurance is the most widely purchased of all property-liability insurance. Drivers buy auto insurance for economic protection against theft, vandalism, and other risks, but many people are not familiar with what their policy covers.

WHY AND HOW ARE POLICIES PRICED FOR DIFFERENT DRIVERS?

For various reasons, drivers are categorized by:   

Gender--Young men have more accidents on the road than young women.

Age--Most drivers under 30 are considered at higher risk of having an accident.

Marital Status--Young married drivers tend to have fewer accidents than young single drivers.

Personal Driving Record--Years of driving experience, accidents, speeding tickets and drunk-driving offenses are all factors in determining how much risk you pose as a motorist.

How you use your vehicle--If you commute by car during rush hours, you’re at greater risk of having an accident than if you only drive for errands and recreation on weekends. Drivers who use their own vehicles for business also are considered at greater risk.

Type of vehicle--The value, size, weight, age of your vehicle--even the cost of replacement parts--are essential to determining the price of your insurance. Larger, heavier vehicles are considered at lower risk than smaller, lighter ones. Plus, more expensive cars are costlier to have repaired than economy models.

Auto Discounts offered:

SAFE DRIVER	MULTI-CAR	ANTI-THEFT DEVICE
PREFERRED DRIVER	NON-SMOKER	PASSIVE RESTRAINT
AUTO/HOME	ANTI-LOCK BRAKES	RENEWAL CREDIT

Do you want to know what Bodily Injury coverage is?  Maybe you are unsure what medical payments really covers?   For answers to these and other coverage questions go to our Types of Coverage's page.

Automobile Insurance Quote for the state of NH only Personal Information Name:  Mailing Address:  Street Address:  Town:    State:  NH    Zip: Daytime Phone:   Night Time Phone: Best Time to Call: E-mail Address: Current Information Current Insurance Company:(enter none, if no insurance currently) Expiration date:    Premium: $ Term: Annual Semi-annual other   Driver Information
	First Driver				Second Driver
Name:
Occupation:
Date of Birth:
Marital Status:	Choose one Married Single Divorced Single w/custody of children				choose one Married Single Divorced Single w/custody of children
Relationship:	Choose one Self Spouse Child Other				choose one Spouse Self Child Other
License #
State Licensed
Years Driving:
Driver Training:	N/A Yes No				N/A Yes No
Good Student:	N/A Yes No				N/A Yes No
Convictions, past 5 years	Date:				Date:
Type of conviction:	None Speeding Failure to yield Non-inspection Following to close Improper Turn Improper passing Drug/Alcohol Test Refusal DWI/DUI All other				None Speeding Failure to yield Non-inspection Following to close Improper Turn Improper passing Drug/Alcohol Test Refusal DWI/DUI All other
Convictions, past  5 years	Date:				Date:
Type of conviction:	None Speeding Failure to yield Non-inspection Following to close Improper Turn Improper passing Drug/Alcohol Test Refusal DWI/DUI All other				None Speeding Failure to yield Non-inspection Following to close Improper Turn Improper passing Drug/Alcohol Test Refusal DWI/DUI All other
Accidents in the past 5 years (regardless of fault)	Date                               Description             Amount Paid Injuries N/A Yes No At-fault  N/A Yes No				Date                          Description           Amount Paid Injuries N/A Yes No At-fault  N/A Yes No
License suspended or revoked	No Yes, SR-22 filing not needed Yes, SR-22 filing needed				No Yes, SR-22 filing not needed Yes, SR-22 filing needed
Other claims or losses	None Yes, specilfy				None Yes, specify
Vehicle Information- Vehicle #1 Year                               Make                                          Model                    VIN (vehicle identification #)
Use of Vehicle  Choose one Drive to school/work Business Use Do not drive to work		# of miles one  way		# of days per week               What Town/City?
Airbags  None Drivers side Both sides		Anti-lok brakes None 2 wheel 4 wheel		Car Alarm  None Active-push a button/switch Passive-Locking doors activates it
Coverage's
Bodily Injury None $25,000/50,000 $50,000/100,000 $100,000/300,000 $250,000/500,000 $500,000/1,000,000 $500,000 Property Damage None $25,000 $50,000 $100,000   Medical Payments  None $1,000 $5,000 $10,000
Comprehensive deductible No coverage $0 (ACV) $100. $200. $250. $500.   Collision deductible  No Coverage $0 (ACV) $200. $250. $500. $1,000.
Towing None $25./disablement $50./disablement $75./disablement   Rental Reimbursement  None $15./day $20./day $30./day $40./day $50./day
Vehicle #2 Year                                Make                                          Model                      VIN (vehicle identification #)
Use of Vehicle  choose one Drive to school/work Business Use Do not drive to work		# of miles one way		# of days per week          What Town/City?
Airbags  None Drivers side Both sides		Anti-lok brakes None 2 wheel 4 wheel		Car Alarm  None Active-push a button/switch Passive-Locking doors activates it
Coverage's
Bodily Injury None $25,000/50,000 $50,000/100,000 $100,000/300,000 $250,000/500,000 $500,000/1,000,000 $500,000 Property Damage None $25,000 $50,000 $100,000   Medical Payments  None $1,000 $5,000 $10,000
Comprehensive deductible No coverage $0 (ACV) $100. $200. $250. $500.   Collision deductible  No Coverage $0 (ACV) $200. $250. $500. $1,000.
Towing None $25./disablement $50./disablement $75./disablement   Rental Reimbursement  None $15./day $20./day $30./day $40./day $50./day
Vehicle #3 Year                                Make                                           Model                   VIN (vehicle identification#)
Use of Vehicle  Choose one drive to school/work Business Use Do not drive to work		# of miles one way		# of days per week              What Town/City?
Airbags  None Drivers side Both sides		Anti-lok brakes None 2 wheel 4 wheel		Car Alarm  None Active-push a button/switch Passive-Locking doors activates it
Coverage's
Bodily Injury None $25,000/50,000 $50,000/100,000 $100,000/300,000 $250,000/500,000 $500,000/1,000,000 $500,000 Property Damage None $25,000 $50,000 $100,000   Medical Payments  None $1,000 $5,000 $10,000
Comprehensive deductible No coverage $0 (ACV) $100. $200. $250. $500.   Collision deductible  No Coverage $0 (ACV) $200. $250. $500. $1,000.
Towing None $25./disablement $50./disablement $75./disablement   Rental Reimbursement  None $15./day $20./day $30./day $40./day $50./day
Miscellaneous information or comments? Please list any additional drivers or driver information or any additional vehicles here.
Are you a homeowner? Yes    No  (most companies offer a discount if they write your auto and homeowners.)  If you wish a homeowners quote please complete our homeowner quote form by clicking here.

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The information you have provided is for quotation purposes only and will be kept completely confidential.  No coverage is bound and the quote may be subject to additional underwriting criteria.

When completed, click on Submit Form ONE time and we will forward your quote to you in the form you have requested.  If you have any questions, please feel free to contact us at 603-382-9211 or 800-295-9211

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