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888.655.6507

About
- Leadership & Advisors
- Career Opportunities
Business Insurance
Employee Benefits
- Group Benefits
- Voluntary & Supplemental Products
Personal Insurance
Claims Management
- Report a Claim
- Situation Room
  - National Weather Service
  - Weather-Ready Nation
Blog
Contact Us
- Career Opportunities

Property

Home
Property

Property

Reported By*
Phone*
Contact Information
Name

First

Last
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Res, Phone
Cell Phone
Bus Phone
Email
Policy Information
Insured*
Name*

First

Last
Policy Number
Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Res. Phone*
Cell Phone
Bus. Phone
Is there a Mortgagee?
Remarks/Other Insurance*
Loss Information
Date of Loss*
Time of Loss
:
HH

MM
Location of Loss*
City
State
Police or Fire Dept to which Reported
Probable Amount of Entire Loss
Loss Type
Description of Loss and Damage*

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Homeowners Quote

Name*

First

Last
Email*
Address

Street Address

Address Line 2

City

State

ZIP Code
Home Phone*
Work Phone
Fax
Mobile Phone
Best time to call
Owner 1 – Date of birth
Owner 2 – Date of birth
If Over 50, Do You belong To AARP?
- Yes
- No
Bankruptcy In Last 5 Years?
- Yes
- No
Occupation
How Long At Present Job?
How Long At Present Address?
Current Insurance Information
Insurance Company Name
Home Now Insured For
Policy Expiration Date
Number Of Claims In Last 3 Years?
Home Information
Square Footage Of Home (excluding garage & basement)
Year Home Was Built
Stories
Construction
Garage
Garage Type
Bathrooms: Full Bath
Bathrooms: Half Bath
Other Features
- Central A/C
- Woodstove
- Wet Bar
- Central Vaccum
- Security System
- Whirlpool Tub
Fireplaces Number Of Chimneys
Fireplaces Number Of Hearths
Basement Finished?
- Yes
- No
Jewelry $
Earthquake
- Yes
- No
Flood
- Yes
- No
Backup Of Sewer Or Drain Coverage
- Yes
- No
How would you prefer we contact you?
Attachments
Drop files here or
Message
Disclaimer Notice – The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

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Charlotte Office – Headquarters

Physical Address:
Two Fairview Center
6230 Fairview Road, Suite 106
Charlotte, NC 28210-3253

Mailing Address:
PO Box 32008
Charlotte, NC 28232-2008

Contact:
704.247.3000
888.655.6507 (toll free)
704.247.3050 (fax)
info@windinsgroup.com

Pawleys Island Office

Physical Address:
267 Willbrook Boulevard, Unit B
Pawleys Island, SC 29585-8618

Mailing Address:
267 Willbrook Boulevard, Unit B
Pawleys Island, SC 29585-8618

Contact:
843.314.2300
888.655.6507 (toll free)
843-314-2317 (fax)
info@windinsgroup.com

Hilton Head Office

Physical Address:
South State Bank Building
2 Palmetto Bay Road, Suite 200
Hilton Head, SC 29928-3278

Mailing Address:
South State Bank Building
2 Palmetto Bay Road, Suite 200
Hilton Head, SC 29928-3278

Contact:
843.341.0080
888.655.6507 (toll free)
843-314-2317 (fax)
info@windinsgroup.com

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