Personal Lines- New Business Checklist

This form is used for Personal Lines new business client to the agency. Rewrites or cross-sold policies should be completed on their specific checklist

Step 1 of 13

Household Information

Named Insured(Required)

First Last

Email(Required)

Secondary Named Insured

First Last

Secondary Email

Phone(Required)

Issued State(Required)

Lines Sold(Required)

Auto

Homeowners – HO3/HO4/HO5/HO6/DIC

Landlord – DP1/DP2/DP3

Umbrella/Excess Liability

Personal Articles/Inland Marine

Watercraft

Earthquake

Flood/Landslide

Recreational Vehicles – Motorcycle/ATV/Snowmobile

Camper/RV/Trailer

Other

Please type another option here.(Required)

Auto Insurance

Effective Date

MM slash DD slash YYYY

Auto Carrier

Did you enroll in Cincinnati RideWELL UBI program?

Did you add the Cincinnati auto plus or capstone endorsement?

Auto plus and capstone endorsements are what give full glass, OEM, and other coverage benefits.

Did you enroll in Encompass Connected Driver UBI App?

Did you put SMARTride or SMARTmiles on this policy?

SMARTride

SMARTmiles

No UBI on the policy

Did you enroll the insured with the paperless discount?

Did you enroll the insured in the Progressive Snapshot Program?

Did you enroll in Safeco RightTrack?

Did you rate any Safeco vehicles as low mileage?

Is the homeowners discount applied to the Safeco auto without having a corresponding Safeco home policy issued? (This will get audited by Safeco and the discount will be removed without homeownership documentation)

Is Stillwater requiring photos of the vehicle?

Did you enroll in Travelers Intellidrive program?

Do any of the autos have a loan/leaseholder?

Did you already list them on the policy?

Lien/Leaseholders information to add to policy

Please include: what vehicle loan/lease applies to and name of financial institution.

Cancel Previous Insurance

Yes- Agency to cancel on client behalf

No – Insured will cancel their own policies

Information to cancel current insurance

Provide Current insurance company, agent name, policy number, and where to send cancellation. ***If current company, policy # is not provided cancellation will not be processed by service team

Current Dec Page for cancel

Max. file size: 98 MB.

Does the policy have a teen driver receiving good student discount?

Yes

What type of homeownership documentation will be provided?

Declarations page from the insured’s home policy

Recent property taxes statement

Assessor’s record

Mortgage documentation (mortgage bills should be from the last 30 days)

Does the service team need to collect grades to support good student discount?

Yes

Since you selected NO. Please upload grades.

Max. file size: 98 MB.

Are UM/UIM limits less than BI/PD limits? OR is UM/UIM rejected?

Yes

Since you selected YES. Please upload the UM/UIM rejection/mistmatch limits form to be signed – Upload UM/UIM rejection or reduced limits form

Max. file size: 98 MB.

Is PIP rejected or Medical Expense coverage selected instead of PIP?

Yes

Since you selected YES. Please upload the PIP rejection form – PIP rejection form will be sent by the service team to be signed

Max. file size: 98 MB.

Do you have less than 100/300K limits on this policy?

Yes

Since you selected YES a sign off form will be sent to the insured from the service team acknowledging limits under 100/300K.

Notes to service team

Additional documents that need collected, items that need sent to UW

The carrier you selected does not download policy information into ezlynx. Please manually enter this policy.

Application

You selected a carrier that does not send electronic signatures. Please upload the auto application to be signed

Auto Application

Max. file size: 98 MB.

Checklist will be sent back if application is not attached.

Auto Billing Information

How was auto downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Since no downpayment was applied please answer "WHY" and how is the policy to be paid?

It is the issuing consultants job to collect downpayment. Service team will send back to issuing agent if downpayment is not collected upon issuance.

Billing Notes

Home Insurance

Effective Date

MM slash DD slash YYYY

Home Carrier

What home product package did you select for this ASI/Progressive home policy?

Home Shield

Home Shield Plus

Platinum

No Package policy

Travelers offers buried utility lines coverage. Did you put this coverage on this home policy?

Yes

Travelers offers water seepage coverage. Did you put this coverage on this home policy?

Yes

Travelers offers water seepage coverage. Did you put this coverage on this home policy?

Yes

Travelers offers matching roofing and siding coverage. Did you put this coverage on this home policy?

Yes

Safeco offers water seepage and leakage coverage. Did you put this coverage on this home policy?

Yes

Safeco offers equipment breakdown coverage. Did you put this coverage on this home policy?

Yes

Nationwide offers a FREE Smart Home Monitoring Program. Did you apply this discount and enroll the insured in this program?

Yes

Did you put the Crestbrook Protection endorsement on this home policy?

Yes

Nationwide Private offers a flood insurance endorsement. Did you offer this coverage on the home policy?

Yes

Nationwide offers service line coverage. Did you put this coverage on this home policy?

Yes

Nationwide offers equipment breakdown coverage. Did you put this coverage on this home policy?

Yes

Did you put the Nationwide Protection Boost endorsement on this home policy?

Yes

Progressive is strict with dog breed recognition. Does the insured have a dog?

Yes

What breed of dog?

This will be sent to Progressive underwriting to disclose dog recognition

Did you add the buried utility lines coverage to their Progressive home policy?

Yes

Did you add the equipment breakdown coverage to their Progressive home policy?

Yes

Did you apply the automatic water shut-off valve discount and enroll your insured in the Guard – Guardian FREE automatic water shut off system?

Yes

Guard offers service & buried utility lines coverage. Did you put this coverage on this home policy?

Yes

Does the agency control the auto insurance for this Guard customer?

Yes

Did you apply equipment breakdown coverage to this Guard policy? (home system protection endorsement)

Yes

Did you apply the automatic water shut off system to Cincinnati home policy? Or enroll them in the PHYN or Leak Defense discount program?

Yes

Did you apply the Cincinnati Service Line Coverage Endorsement?

Yes

Did you apply the Cincinnati Equipment Breakdown Endorsement?

Yes

Cincinnati offers flood insurance endorsement. Did you apply this endorsement to the home policy?

Yes

The carrier you selected does not download policy information into ezlynx. Please manually enter this policy.

Additional Interests

Mortgage Company, Loan Number, Or note that EOI Binder is in documents tab

Cancel Previous Insurance

Yes

No – Insured to cancel

Cancel Previous Insurance

If Current company and policy # are not provided service team will not process cancellation

Is the alarm discount applied to this policy?

Yes

Does the service team need to collect an alarm certificate?

Yes

Since you selected NO please upload the alarm certificate

Max. file size: 98 MB.

Are there items scheduled on this policy that require proof of value?

Yes

List what appraisals need to be collected

Does a Trust or LLC need to be added to the home insurance policy?

Yes

What is the name of the Trust or LLC that needs to be listed?

Additional security discounts that require proof

Water shut off valve, seismic updates, water heater straps, etc

Notes to service team

Billing Information

How is the home downpayment to be applied?

Title Company Check/New Closing

Mortgage Company Paid/Escrowed

EFT

Credit Card

Personal Check

No downpayment

Other

Do billing accounts need to be combined?

Yes

What policies need to be combined?

Since you selected Title Company Paid. Please provide the name and contact information for the lender so we can track down the payment if not received after closing

Provide Name, Email Address, Phone, Etc.

Since you selected mortgage company paid. Do we need to send an invoice and the policy documents to the mortgage company?

Yes

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Since no downpayment was applied please answer "WHY" and how is the policy to be paid?

It is the issuing consultants job to collect downpayment. Service team will send back to issuing agent if downpayment is not collected upon issuance.

Please type another option here:

Billing Notes

Landlord Insurance

Effective Date

MM slash DD slash YYYY

Landlord Carrier

Is the Landlord policy owned in the name of a Trust or LLC?

Yes

What is the name of the Trust or LLC it is listed in?

Billing Information

How is the landlord downpayment to be applied?

Title Company Check/New Closing

Mortgage Company Paid/Escrowed

EFT

Credit Card

Personal Check

No downpayment

Other

Since you selected Title Company Paid. Please provide the name and contact information for the lender so we can track down the payment if not received after closing

Provide Name, Email Address, Phone, Etc.

Since you selected mortgage company paid. Do we need to send an invoice and the policy documents to the mortgage company?

Yes

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Since no downpayment was applied please answer "WHY" and how is the policy to be paid?

Type here… It is the issuing consultants job to collect downpayment. Service team will send back to issuing agent if downpayment is not collected upon issuance.

Please provide another option here:

Umbrella/Excess Insurance

Effective Date

MM slash DD slash YYYY

Umbrella Carrier

What liability umbrella/excess limit did you issue?

$1 Million

$2 Million

$3 Million

$4 Million

$5 Million

$6 Million

$7 Million

$8 Million

$9 Million

$10 Million

$15 Million

$20 Million

$25 Million

Other

You selected a carrier that offers the excess UM/UIM endorsement. Did you add this to your liability umbrella policy?

Yes

Does the excess carrier also insure all underlying policies?

Yes

Since you selected "NO" who are the underlying carriers?

We need to upload proof of insurance to the excess carrier

Umbrella Billing Information

How was Umbrella/Excess Liability downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Personal Articles/Inland Marine

Only complete if this is a stand alone policy. If it is an endorsement on the home please complete on homeowners section of checklist

Effective Date

MM slash DD slash YYYY

Carrier – Personal Articles/Inland Marine

What items are insured on this personal collections policy?

Jewelery

Fine Art

Sporting Equipment

Wine

Collections

Silver

Firearms

Antiques

Other

Are appraisals or proof of value required for your scheduled items?

Yes

Since you selected "YES" please upload your appraisal or proof of value

Max. file size: 98 MB.

Cancel Previous Insurance

Yes

Cancel Previous Insurance

If Current company and policy # are not provided service team will not process cancellation

Billing Info

How was personal articles/inland marine downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Watercraft

How was the watercraft downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Earthquake

How was the earthquake downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Flood / Landslide

How is the flood/landslide downpayment to be applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Billing Notes

Recreational Vehicles – Motorcycle/ATV/Snowmobile

How was the recreational vehicles downpayment applied?

Title Company Check/New Closing

Mortgage Company Paid/Escrowed

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Camper / RV / Trailer

How was the RV/Camper/Trailer downpayment applied?

EFT

Credit Card

Personal Check

No Downpayment Applied

Other

Please type another option here:

Since you selected EFT please upload the EFT form to be signed

Max. file size: 98 MB.

Do billing accounts need to be combined?

Yes

Billing Notes

Other

Please type another option here:

Policy Servicing

Follow Up Items

Electronic Signatures – Select only if carrier does not offer it

BOR request

Carrier UBI/Telematics explanation/enrollment reminder sent to insured

Carrier website or APP instructions sent to insured

Does Mailing address need to be changed after effective date? (real estate closing)

Yes

Ezlynx Campaign Enrollment

Please select all campaigns client needs to be enrolled in.

Home Refund Reminder (select if using refund for policy payment)

Loan Sold Reminder

Birthday

Nationwide Private Client Travel Assist

Nationwide Private Client Water Shutoff partnership

Nationwide private client smart home partnership

Travelers Phone Survey

Other

Cross Sell

What additional policies were added to this account?

Umbrella

Earthquake/Stand Alone

Flood

Additional residence/Landlord

Personal Articles/Landlord

Personal Articles

Boat

ATV/UTV

Camper/RV

Other

Additional Policy Notes

Send Out Cards

Send Thank You Card to Referral Source(Required)

Yes

Other

Send Thank You Card to New Client(Required)

Yes

Other

Referral Source Name(Required)

File

Max. file size: 98 MB.

Finalize

File

Max. file size: 98 MB.

File

Max. file size: 98 MB.

Have you listed lead source in ezlynx? (No Lead source 30% commission)

Yes

Other

If this is a rewrite or remarket, did you update the policy in ezlynx to reflect ReWrite, not New Business?

Other

Joint Consultant

Also list percentage split

Which personal lines service division does this apply to?(Required)

hCaptcha(Required)

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