Philbin Insurance Group
(617) 389-9400
    Our offices will be closed on Thursday, June 8th for our Quarterly Agency Meeting. We will continue normal business hours on Friday, June 9th. We apologize for any inconvenience. Thank you

Discount Protection Survey

Discount Protection Survey
CLIENT INFORMATION
Email:

Cell Number:

Work#:

Occupation:

AGENCY CLIENT CODE
Cell#:

Email:

Work#:

Occupation:

AUTO PROTECTION QUESTIONS
Does our agency insure ALL of your household cars?:

Have you acquired any new vehicles not listed on your policy?:

Are all licensed drivers in your household listed on your policy?:

Are there any licensed drivers a student with a B or above average?:

Are there any licensed drivers who have taken a defensive driving course?:

Are there any licensed drivers away at school?:

Are there any hybrid or electric vehicles?:

Are any vehicles garaged at another location?:

Are there any non-household residents that normally drive your car?:

Are there any vehicles used in connection with a business?:

HOME PROTECTION QUESTIONS
Does our agency insure ALL of your properties/home?:

Do you have a pool?:

Does your home have a central burglar or fire alarm?:

Have you done any significant renovations or additions in the last 3 years?:

Do you have a Temperature Monitoring Device?:

Do you Winterize your plumbing? (Discount of secondary homes):

Do you service your Heating Unit annually? (Discount on secondary homes):

Do you have a Hard-Wired Generator permanently installed?:

Does your Sump Pump have a Battery Backup System?:

Do you have a Water Leak Detection and Control System?:

Does your home have a Lightening Rod Protection System?:

Do you have Hurricane Shutters?:

Do you have a Shatter Resistant or Hurricane Proof Windows?:

Do you run a business from your home?:

DO YOU OWN ANY OF THE FOLLOWING
Check all that apply
Any Collector Items
Art Work
ATV
Baseball Cards
Golf Carts
Golf Clubs
Guns
Jet Ski
Over $5,000 in Jewelry
Moped
Musical Instruments
Snowmobile
HOUSEHOLD UPDATES
What year was your heating and cooling system last updated?:

What year was your roof last replaced?:

What year was your plumbing replaced?:

What year was your electric last updated?:

GENERAL QUESTIONS
Do you have any specific questions on an area of insurance that we may research for you? Comments:

Do you have any suggestions on how we could improve the Agencys Service?:

Do you have any specific expectations or special requests we may work on for you?:

Other than price, what is most important to you when it comes to Insurance? Please select a number 1 through 4 (1 being the most important)
Agency Service:

Insurance Company:

Protection of Assets:

Claim Service:






Get a Quote
or call
617-389-9400

Find out more


Mailing Address


220 Broadway Suite #304
Lynnfield, MA 01940

BUSINESS HOURS Everett Office Lynnfield Office


MONDAY to THURSDAY
Phone Lines: 7:00am - 6:00pm
Office Hours: 8:30am - 5:00pm

FRIDAY
Phone Lines: 7:00am - 3:00pm
Office Hours: 8:30am - 3:00pm

SUMMER HOURS: Close at 1:00pm on Friday
© Philbin Insurance Group, All Rights Reserved. DreamingCode, Inc.