Auto Insurance

Personal Auto Insurance Without the Call Center

Independent Choice

We don't work for one insurance company; we work for you. We shop multiple carriers to find the right policy fit.

Direct Access

Skip the 1-800 numbers and automated hold queues. You get a dedicated, licensed agent right here in Lake Forest.

Tailored Protection

We don't believe in one-size-fits-all policies. We build your coverage around your specific assets, ensuring you only pay for the protection you actually need.

Ways you can Save

Good Driver

Rewards for those who prioritize safety on California Roads.

Good Student

Significant savings for high-achieving scholars and families.

Professional Savings

You could qualify for lower rates based on what you do for a living. Special pricing is available for over 200 professional fields.

Ready to see how much you can save?

Get a personalized, hassle-free quote from our team. Fill out the quick details below to get started.

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Are you currently insured? *

Driver Information

How many drivers? (including yourself)

Your date of birth *

Date you were first licensed *

Your marital status *

What is your occupation? (not required, but certain discounts may apply)

Have you had any accidents or driving violations in the past 5 years? *

Date of accident / violation *

Please provide a brief description of the accident / violation *

Name of Driver #2 *

First

Last

Relationship to you

Spouse
Child
Relative
Roommate

Date of birth *

Date first licensed *

Marital status *

What is their occupation? (not required, but certain discounts may apply)

Any accidents or driving violations in the past 5 years? *

Date of accident / violation *

Please provide a brief description of the accident / violation *

Name of Driver #3 *

First

Last

Relationship to you

Spouse
Child
Relative
Roommate

Date of birth *

Date first licensed *

Marital status *

What is their occupation? (not required, but certain discounts may apply)

Any accidents or driving violations in the past 5 years? *

Date of accident / violation *

Please provide a brief description of the accident / violation *

Name of Driver #4 *

First

Last

Relationship to you

Spouse
Child
Relative
Roommate

Date of birth *

Date first licensed *

Marital status *

What is their occupation? (not required, but certain discounts may apply)

Any accidents or driving violations in the past 5 years? *

Date of accident / violation *

Please provide a brief description of the accident / violation *

Name of Driver #5 *

First

Last

Relationship to you

Spouse
Child
Relative
Roommate

Date of birth *

Date first licensed *

Marital status *

What is their occupation? (not required, but certain discounts may apply)

Any accidents or driving violations in the past 5 years? *

Date of accident / violation *

Please provide a brief description of the accident / violation *

Vehicle Information

How many vehicles do you need to insure?

For car #1 do you have the VIN? *

Please enter the VIN *

Year *

Make *

Model *

Approximate date of purchase *

What will this car primarily be used for? *

Work/School
Pleasure
Business
Uber/Lyft

How many miles per year will this car be driven? *

Exact odometer reading *

For car #2 do you have the VIN? *

Please enter the VIN *

Year *

Make *

Model *

Approximate date of purchase *

What will this car primarily be used for? *

Work/School
Pleasure
Business
Uber/Lyft

How many miles per year will this car be driven? *

Exact odometer reading *

For car #3 do you have the VIN? *

Please enter the VIN *

Year *

Make *

Model *

Approximate date of purchase *

What will this car primarily be used for? *

Work/School
Pleasure
Business
Uber/Lyft

How many miles per year will this car be driven? *

Exact odometer reading *

For car #4 do you have the VIN? *

Please enter the VIN *

Year *

Make *

Model *

Approximate date of purchase *

What will this car primarily be used for? *

Work/School
Pleasure
Business
Uber/Lyft

How many miles per year will this car be driven? *

Exact odometer reading *

For car #5 do you have the VIN? *

Please enter the VIN *

Year *

Make *

Model *

Approximate date of purchase *

What will this car primarily be used for? *

Work/School
Pleasure
Business
Uber/Lyft

How many miles per year will this car be driven? *

Exact odometer reading *

Coverage Options

How much Bodily Injury Liability coverage would you like? *

$30,000 per person / $60,000 each accident
$50,000 per person / $100,000 each accident
$100,000 per person / $300,000 each accident
$250,000 per person / $500,000 each accident
$300,000 per person / $300,000 each accident
I don't know

*If you are responsible for a car accident, this coverage pays for the medical costs of the people who are injured (not including yourself). This coverage also helps cover payment for legal defense in the event you are sued for damages.

How much Property Damage Liability coverage would you like? *

$15,000 each accident
$25,000 each accident
$50,000 each accident
$100,000 each accident
$250,000 each accident
$300,000 each accident
I don't know

*This coverage helps pay to repair damage you cause to another person's vehicle or property.

How much Uninsured Motorist Bodily Injury coverage would you like? *

$30,000 per person / $60,000 each accident
$50,000 per person / $100,000 each accident
$100,000 per person / $300,000 each accident
$250,000 per person / $500,000 each accident
$300,000 per person / $300,000 each accident
I don't want this coverage
I don't know

* This covers you and the people in your car for medical bills, lost wages and pain and suffering if you're in an accident caused by someone who doesn't have insurance or enough insurance.

How much Medical Expense coverage would you like? *

$500
$1,000
$2,000
$5,000
I don't want this coverage

*If you or your passengers are injured in a car accident, this coverage may help pay for medical expenses.

What would you like your Comprehensive coverage deductible to be? *

$50
$100
$250
$500
$1,000
I don't know
I don't want this coverage

*Comprehensive coverage helps cover damages to your vehicle that were caused by something other a collision (theft, vandalism, hail, animal, etc.). *A deductible is the amount you are responsible for paying, before coverage will come forward.

What would you like your Collision coverage deductible to be? *

$100
$250
$500
$1,000
I don't want this coverage
I don't know

*Collision coverage helps pay to repair or replace your car if it's damaged in an accident with another vehicle or object. *A deductible is the amount you are responsible for paying, before coverage will come forward.

How much Roadside Assistance coverage would you like? *

$75 per disablement
$500 per disablement
$1,000 per disablement
I don't want this coverage

*This coverage can help in the event that you are having car trouble on the side of a road, at work, or at home. Roadside Assistance can help with services such as changing a flat tire, towing your car to a repair shop, or jump starting a dead battery.

How much Rental Car Reimbursement coverage would you like? *

$40 per day / max 30 days
$50 per day / max 30 days
$70 per day / max 30 days
$100 per day / max 30 days
I don't want this coverage

*Rental Car Reimbursement coverage pays the cost of a rental vehicle while repairs are made to your car due to a covered loss.

Discounts

Would any driver qualify for the discounts listed below? (Check all that apply)

Membership with Costco, AAA, or Sam's Club
Federal government employee
Scientist or Engineer
Educator
Pilot
Bank of America employee
Law Enforcement Officer, EMT, or Fire Fighter
Member of California Society of CPAs
Member of California Medical Association
Member of a Homeowners Association
Member of an Alumni Association
Bachelors degree in a medical field
Member of a retiree group

Would any driver in your household qualify for the Good Student discount?

*Full-time enrollment in school required (12 or more units), with a GPA of 3.0 or higher.

Please indicate who would qualify for this discount

Contact Information

How should we contact you? *

Email
Phone
Both

Email *

Phone

Comments

Date / Time

Date

Time

Auto Insurance

Personal Auto Insurance Without the Call Center

Independent Choice​

Direct Access​

Tailored Protection​

Ways you can Save

Good Driver

Good Student

Professional Savings

Ready to see how much you can save?

Driver Information

Vehicle Information

Coverage Options

Discounts

Contact Information

Independent Choice

Direct Access

Tailored Protection