ABBOTT & FILLMORE AGENCY, INC.'S 
INSURANCE ARIZONA ON THE NET!
AUTO INSURANCE QUOTE SHOPPER
NO HASSLE, COMPARISON QUOTES AND APPLICATIONS
-We shop for you, put coverage in force for you, and protect you!-
This site is for auto insurance quotes for Arizona  click here for Indiana or click here for Michigan
We Compare Several Top Companies For You

A Service of   www.insurancearizona.net

If you have a problem with alignment of form boxes, try reducing your viewing font!

After submitting the requested information, we will calculate quotes from SEVERAL different insurance companies. Of course, no coverage is bound and any quote is subject to company approval and underwriting criteria.

Special Note: It is best to have us look at both home/renters AND auto concurrently so as to compare special insurance package discounts! When done, go to homeowners quote, too.

When you get the quote, if you are want to move forward, we make it SIMPLE!  This is our "No Hassle" service.

Please enter the following information (Be sure you have your existing policy in front of you):

READ THIS! This quote service is intended only for someone who has insurance presently and has their existing policy in front of them.  An existing policy number and vehicle id numbers must be provided for a response.  If you don't have current insurance or if you are just checking the cost of insurance on a car you don't currently have insured, you can still call us at   800-243-6296 for a phone quote.  There will be no response to this online quote request if a current, valid policy number is not included.  Therefore, YOU MUST HAVE YOUR EXISTING POLICY IN FRONT OF YOU WHEN YOU COMPLETE THIS!  This helps us make sure we give you "apples-to-apples" and accurate figures.

HOUSEHOLD INFO: (Note: All information is held strictly confidential!  We do not sell or give any information to any other company or organization other than the carriers we check with to provide you with a quote.)

Your full name:     
Your occupation & employer
Spouse occupation/employer:
Your email address:              
Your home phone number:    
Your work phone number:    
Your home street address:    
Your city:                             
Your state:                           
Your ZIP Code:                   
Number of People in House:


Choose One: Own Mobile Home<10 yrs old;   Own Home; Rent;  Live w Parents; Other
What company insures your home/personal property?

We can likely save you the most money by packaging your auto insurance with either a homeowners policy or a renters policy with our special "Multi-Policy" discounts!!  When you are done here, grab that policy and go to our homeowners quote page.  There is a link at the end of this input.


Medical Ins. Company or NONE:   
Disability Ins. Company or NONE:   If you have a disability plan through work that would pay your lost income if you couldn't work due to auto accident injuries.

Do you have Auto Ins in force now?  IF NOT, STOP HERE AND CALL US FOR QUOTE.
If so, Current Auto Ins. Co.:             
Policy Number:                               There will be no response to your request if not included.
Expiration Date:                               
Current 6 mo premium                     
Are you being cancelled by your current company?  If so, WHY?
Are you a member of a group (College Alumni Assoc., AARP, MEA, Mi Assoc Comm Bankers, etc.) 

HOUSEHOLD INFO: List info on ALL household members including yourself (even if they don't drive) AND any other drivers

Social Security Number Note: Some companies give a discount that depends on credit rating. Thus, a credit report will be ordered to determine if you are eligible for a discount. We do not ever see the credit report.  The company's computer looks it up and we are told at which level of discount, if any, you qualify without any other information on your credit report.
    
(include yourself
again as #1)

Full Name including full middle name

Birthdate

Social Security Number

Any ticket/accident last 5 yrs?
Household Member # 1 see note

Y or N

Household Member # 2   Y or N
Household Member # 3   Y or N
Household Member # 4   Y or N
Household Member # 5   Y or N
 
Are there any more household members? No  Yes;   If so, please list their info at the end in "Other Comments".
TICKETS AND/OR ACCIDENTS IN LAST 5 YEARS FOR ALL HOUSEHOLD MEMBERS AND DRIVERS; PLEASE LIST DETAILS     
Please give all details on any tickets or accidents for all members of the household during the last 5 years.
Be sure to include 1) name of driver, 2) date of occurrence, 3) description of occurrence, and 4) amount of claim if applicable.  If there have been absolutely none, please state "None"
 
.
CLAIM DETAILS IN LAST 5 YEARS.  Please describe all claims you have had in the last 5 years including deer, windshield, theft, accidents (including "not at fault"), etc..  Provide details, dates, and amounts paid for the claim.  If there have been absolutely none, please state "None"
(You can keep typing past the end of the box)
 

  AUTO INFORMATION - Vehicles 1 & 2   

  Car1 Car2
Year
Make
Model
VIN # (Required)
Title is in Name of ?
Anti-Lock Brakes?
Air Bags (0, 1, 2 or 2 +side)
Alarm System?
Driver's Name
Use (Work, School, Business or Pleasure)
Distance One Way
Note: If car is driven to work/school less than 5 days/ week; please describe circumstances in "Extra Comments" 
 
      AUTO INFORMATION - Vehicles 3 & 4   
 
  Car3 Car4
Year
Make
Model
VIN # (Required)
Title is in Name of ?
Anti-Lock Brakes?
Air Bags (0, 1, 2 or 2 +side)
Alarm System?
Driver's Name
Use (Work, School, Business or Pleasure)
Distance One Way
Note: If car is driven to work/school less than 5 days/ week; please describe circumstances in "Extra Comments" 
     
 
COVERAGES 
 
Specific Car Coverages - Vehicles # 1 and # 2 from above:
  Car 1 Car 2
Comprehensive - Choose One
Collision-Choose One
Collision Type: 
"Broad" collision is the best (and most expensive). With "Broad" you do NOT pay the deductible if the OTHER person is "at fault".  With "Regular" you pay the deductible no matter what;
Road Service/Towing?
Car Rental Coverage?
This car's current 6 mo premium:
  
       
Specific Car Coverages - Vehicles # 3 & # 4:
  Car 3 Car 4
Comprehensive - Choose One
Collision-Choose One
Collision Type: 
"Broad" collision is the best (and most expensive). With "Broad" you do NOT pay the deductible if the OTHER person is "at fault".  With "Regular" you pay the deductible no matter what;
Road Service/Towing?
Car Rental Coverage?
This car's current 6 mo premium:
  

Coverages That Apply to All Vehicles

Bodily Injury Liability Limits

Please choose a liability limit from the limits listed below. Limits are per person/per occurance. Limits will be the same for all vehicles.  This covers you if you injure someone and they sue you. With law suits the way they are today, we recommend the highest limits possible.  We also recommend that you obtain an umbrella policy to "blanket" over your home and auto insurance.  Ask us about it.

Property Damage Liability Limits:

Please choose a property damage liability limit from the list below. Limits will be the same for all vehicles. This covers you if you damage someone's property (ie parked car, house, etc.) and they sue you.
     

                
Medical Payments

Please choose the Medical Payments coverage limit you would like from the list below:

Enter your Medical choice     

Do you wish to have your Medical Payment coverage be Excess of other coverage?

.     

Good Student Discount Note: If any of the drivers is a full time student and on the honor roll/dean's list, please let us know in the extra comments section.  You may be eligible for a "Good Student Discount"

Extra comments; enter additional household member info, additional autos, good student info, etc.:

 Did you fill in all the information?  Did you have your existing policy in front of you to ensure "apples-to-apples"?

How did you find our site? 

If "Other search engine" or just "Other", which search engine or where?

Did you find our quote form easy to use?  Put any ideas for improvements here:

Thank you for completing our online quote form. Please let us know how you would like us to send you the quote:
 Phone Call     Fax  
If you entered "phone call"and we call at night, how late can we call you?
If you entered "Fax", what is your fax number: