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This is a quote request for renters insurance in the state of South Dakota. Renters insurance covers the personal property of those living in an apartment or renting a house. It also provides liability and medical payments coverage. There is absolutely no obligation to purchase insurance by filling out this form. And, no insurance coverage can be bound by filling out this form. If coverage is later requested, an application for insurance will need to be signed and a down payment of premium made. Any rates given are subject to the companies final review and approval.


Contact Information

  Name 
  Address 
  City, State ZIP 
  Phone 
  E-Mail 
  FAX 


Applicant Information

  First Name  
 
 
  Last Name  
 
 
  Birth Date  
 
 
  Social Security #  
 
 


Residence Information

  What type of building do you live in?    
  List the street address of the house   
  if different from the address above.  


Coverage Amounts
click here for description

   Personal Property   
 $
 
   Personal Liability   
   
   Medical Payments   
   


Scheduled Personal Property
click here for description

 Do you own any jewelry or other collectible items which you 
 would like specifically scheduled on your insurance policy? 


Additional Information

Explain all "yes" answers in the space below.
  Is there any business conducted at this residence? 
  (example: daycare, incidental office, etc.) 
  yes  
  no  
  Do you own any watercraft, snowmobiles, or all- 
  terrain vehicles?  (List type and HP or CC's.) 
  yes  
  no  
  Do you have a wood stove or wood-burning  
  fireplace? 
  yes  
  no  
  Do you have a dog? If yes list the number of dogs  
  and their breeds. 
  yes  
  no  


Insurance History

  List your current insurance company  
  and the policy expiration date:  
Company 
 
Exp. Date
  List all insurance claims you have  
  had at this residence in last five years  
  including dates, type and amounts:  
  


Comments



When you are finished filling out this form, click on the "quote" button below to send the information.








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Personal Property - The primary purpose of a renters insurance policy is to place insurance coverage on your household personal belongings. Take a quick inventory of your personal property and estimate how much it would cost to replace everything you own. The minimum amount of coverage on a renters policy is usually $10,000 and most people, especially families, will require much more coverage than that.

Personal Liability Coverage - Covers payment, on behalf of the insured, for sums of money in which the insured is legally obligated to pay for damages of bodily injury or property damage to others caused by an occurrence arising out of the insured's premises or personal activities.

Medical Payments Coverage - Covers medical expenses incurred by persons, other than the insured, who sustain bodily injury caused by an accident arising out of the insured's premises or personal activities.


click here to return to Coverage Amounts





Scheduled Personal Property - Specific items of household property can be scheduled and given broader coverages than normally provided in the policy for household contents. In most homeowner policies, contents are only insured for the perils listed in the policy (fire, wind, theft, smoke, etc.). However, when specifically sheduled, these items can be insured for all causes of loss unless the cause of loss is excluded in the policy. The coverages provided for scheduled property can be broader and more inclusive than property that is not scheduled. Also, certain classes of property are limited for coverage by the policy (for example: jewelry is limited in the policy for theft coverage) and these internal limits do not apply to scheduled property.

Recreational Vehicles - Watercraft, snowmobiles and ATVs can usually be added onto a homeowners policy. (Sometimes, however, they must be written on separate policies.) List the amount of coverage, year, make, model, and horsepower or CC's in the comments section.


click here to return to Scheduled Personal Property




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