Here at The Hutch Agency, we take our jobs as Insurance Advisors very seriously. We always want to make sure that we’ve done a great job explaining your coverage, and have given you every opportunity to ask questions and make changes. Before we bind your policy, please let us know if there’s anything else we can help with.
PLEASE READ AND ACKNOWLEDGE BELOW:
By signing below I am acknowledging that I (we) have been offered the Highest Limits of Liability available and have been explained the premium differences. I (we) have accepted or rejected those limits as indicated on my application for insurance with the carrier I am applying to. I (we) acknowledge that I have been fully advised of Bodily Injury liability, Property Damage liability, Medical Payments, PIP (if applicable), Uninsured and Underinsured Bodily Injury and Property Damage (where UM/UIMPD applies).
I (we) further acknowledge that I have been explained all the coverage available to me with respect to coverage for my vehicle including but not limited to COMPREHENSIVE, COLLISION, TOWING, RENTAL CAR, LOAN/LEASE GAP COVERAGE, DEATH BENEFIT, DIMINISHING DEDUCTIBLE, BETTER VEHICLE REPLACEMENT COVERAGE. The deductibles I (we) have chosen and the additional coverage I (we) have elected to purchase or reject are correctly displayed on my application for insurance.
If I also purchased home insurance, then I acknowledge that I (we) were explained all the coverage’s available to me (us) including but not limited to Flood, Sewer and Drain Backup, Sinkhole Collapse, Earthquake, Mine Subsidence as well as all the other optional coverage available to me for purchase. I (we) understand the differences between Actual Cash Value and Replacement Cost with regards to the loss settlement of my (our) home and I (we) have selected the option that I (we) want. I (we) understand the limitations of coverage on jewelry, guns, etc. and agree that upon receiving the policy from the carrier I (we) will review it to ensure it is correct as to my wishes. I (we) will advise the agency and the agent of any discrepancies. I (we) acknowledge it is my (our) responsibility to advise my (our) agent of any and all desired coverage as well as changes to my (our) policy including but not limited to additions, alterations, etc. I (we) have been advised that ATV’s and Trampolines have coverage limitations if covered at all under the policy. I (we) will advise the agency should I (we) acquire one of these items and further agree to contact my (our) agent regarding any new acquisition to ensure coverage. I (we) understand that my (our) policy is not all-inclusive pertaining to coverage and that limitations as outlined in the policy do apply. I (we) agree to hold the agency and its agent harmless in the event I (we) have failed to adequately select coverage needed to protect my (our) interests.
I (we) HAVE BEEN ALSO ADVISED THAT THE HUTCH AGENCY OFFERS LIFE INSURANCE AND HAS OFFERED TO PROVIDE ME A QUOTE FOR THIS VERY IMPORTANT COVERAGE. I (we) WILL NOTIFY THE HUTCH AGENCY TO PURCHASE THIS COVERAGE SHOULD I (WE) DESIRE TO PURCHASE IT FROM THEM.
This acknowledgement certifies that the licensed agent representing HUTCHISON INSURANCE AGENCY, INC. DBA THE HUTCH AGENCY has fully explained the above available coverage to me (us) and that I (we) understand the coverage I (we) have elected to purchase as well as those I (we) have elected to reject. Also, I (we) acknowledge reading this form and that I (we) am fully competent and understand the implications and limitation of the insurance limits and coverage I (we) have selected. I (we) further agree to hold the agency and its agent harmless in the event I (we) have failed to adequately select limits of liability and vehicle coverage to protect my (our)interests. I (we) further acknowledge that it is my (our) responsibility to notify the agency within the specified period of any newly acquired vehicles or if any policy changes are desired.