Submit a request

Select whether you would like to add or remove a driver.

Select the format that matches the policy number on your declarations page or ID card.

Please enter the full Policy Number as it appears on your documents.

When should this change take effect?

What is the first and last name of the driver you wish to add or remove?

Enter the drivers learners permit number.

When is this driver expected to take the road test to get their drivers license?

Enter the requested driver's Drivers License number as it appears on the drivers license.

Which state was this drivers license issued in?

Please select the requested driver's gender as it appears on their drivers license.

What is the relationship of the driver you wish to add to the primary named insured?

If yes, please include any photos of the damage in the Description field below.

When did the accident take place?

Were their any injuries as the result of the accident?

Please note that vehicles over 20 years old will not be eligible for Comprehensive or Collision coverage.

Please provide first and last name of the primary driver. This person will need to be added to the policy if they are not already.

Please provide their first and last name. This person will also need to be listed on the policy if they are not already. Please answer "Yes" to the question below asking if you would like to Add a Driver to get them added.

Please note that the registered owner of the vehicle must be listed on the policy. You may add them as a driver below if they are not already on your policy.

Please enter the name and address as it should appear on the policy

A member of our Customer Care team will look into your request and follow up with you by email within 1 business day!

Add file or drop files here