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Automobile Quote

Please complete the information below and remember we are always here to answer your questions.

Contact Information
Name*
Address
 
City
State
Zip
Daytime Phone Number
Nighttime Phone Number
Best Time to Call
Email Address*
* required fields
Current Auto/Motorcycle Insurance Information
Company Name
(not agency)
Policy Expiration Date
Premium Amount
Term
Auto/Motorcycle Information
(include all autos/motorcycles you or your family members own or lease)
Car/Motorcycle One
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Two
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Three
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Car/Motorcycle Four
Year
Make
Model
Body Type
VIN#
Title Holder
Annual Mileage
Usage
Engine Size
Air Bags Yes
No
Car Alarm Yes
No
If vehicle is kept at an address other than that listed above, please indicate below.
Location City
Location State
Location Zip
Liability Limit For ALL Vehicles
(Choose either Bodily Injury and Property Damage or Single Limit)
Bodily Injury
Property Damage
Single Limit
Uninsured/Underinsured
Deductible Information
Vehicle# Comprehensive Deductible Collision Deductible Towing Rental Reimbursement
1 Yes No Yes No
2 Yes No Yes No
3 Yes No Yes No
4 Yes No Yes No
Driver Information
(include all licensed drivers in your household)
Driver One
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Two
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Three
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver Four
Driver Name
License Class
(Standard, CDL, Motorcycle, Bus, etc.)
Drivers License #
State/Province
Number of Years Licensed
Relation
Date of Birth
Sex Male Female
Marital Status
Courses Completed in the last 3 years (drivers ed): Yes No
Driver History
(Please list ANY convictions for ANY driver convicted of moving traffic violations in the past 3 years)
Driver One
Date
Type of Conviction
Fines
Over Limit
Driver Two
Date
Type of Conviction
Fines
Over Limit
Driver Three
Date
Type of Conviction
Fines
Over Limit
Driver Four
Date
Type of Conviction
Fines
Over Limit
Please list ANY driver who has had license suspensions, revocations or DUI convictions below.
Driver License Suspended or Revoked DUI Conviction For
1
2
3
4
Please list ANY driver involved in accidents, regardless of fault, in the past 5 years
Driver One
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Two
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Three
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Driver Four
Date
Description
Cost
At Fault Yes
No
Injuries Yes
No
Additional Information
Please give any additional comments you feel appropriate for this quotation. If you have additional information where there was not enough fields above, such as additional drivers, vehicles, driver histories, etc..., please enter them here.
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What Our Customers Say!

Dear Fletcher, I wanted to drop you a note to say what a pleasure it is to work with your team. Jennifer and Linda are terrific. I'm often faced with challenges when attempting to collaborate and coordinate with my service partners. That is never the case with Wilson Insurance. It is a relief and a calming thought to know I can count on you and your team for support. Thanks for the consideration. Don

Don Smith, Hayward Industries

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What's New

Wilson Insurance Services Team!
2/22/2018

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What You Should Know About Rental Car Insurance
2/1/2018
There are some very serious contractual gaps in coverage for rental vehicles. Even if you purchase their Collision Damage or Physical/ Loss Damage Waivers, many rental car contracts exclude the following:
  • Theft of the Vehicle
  • Tolling, or Turning the Vehicle Over
  • Lease Gap coverage
  • Loss of Use
  • Glass, Tire and Undercarriage Damage
  • Animal Collision
  • Flood and Hail Damage
  • Damage above the Windshield
  • Individuals who rent personal vehicles for extended periods and do not have a Personal Auto policy in force
  • Drivers who rent, and do not own another vehicle insured elsewhere, need to be expecially careful here
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The Five Costliest Traffic Tickets for Auto Insurance
1/15/2018

Those whirling blue lights in the rearview mirror usually mean just one thing: It's traffic ticket time. The worse the violation, the more your car insurance costs may rise because it's more likely you'll be considered a bigger risk to the insurer.  Rack up a combination of the nastiest violations plus a few accidents, and insurers may even refuse to cover you, says Loretta Worters, spokeswoman for the Insurance Information Institute, a trade group.

 
It boils down to matching the premium you pay to your risk as a customer, says State Farm spokesman Dick Luedke. "Sometimes you get lucky and violate (traffic laws) a lot and don't get caught, and sometimes you do it once, and you are caught," he says. "That's why we use all sorts of other things to measure risk as well." So it's tough to say how much your insurance premiums will rise per violation. Different insurers calculate premium costs differently, Worters says. With the help of experts, including J. Robert Hunter, insurance director for the Washington, D.C.-based Consumer Federation of America, we now identify what are considered the five worst traffic violations for your insurance bills:
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