Misc. Changes to my Home, Condo, Tenant or Dwelling

Cameron A. Shandersky, CPCU

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Misc. change(s) to my Homeowner, Condo, Tenant's, Rental Dwelling or Vacation Home policy

* Indicates required question

Full Name: *

(As it appears on your policy)

Your answer

Phone Number: *

Your answer

Email Address: *

Your answer

Choose Policy Type: *

Homeowner Policy (you own it)

Condo Unit Owner Policy (you own the interior of it)

Tenant's Policy (you rent it)

Rental Dwelling (you own it, but rent it to someone else)

Vacation Home (really, just another Homeowner policy)

Choose type of change in Coverage/Exposure: *

(In insurance terms, the word 'exposure' is a risk that may cause a claim. For example, a swimming pool creates a liability exposure.)

Choose

Add a Coverage/Exposure

Change a Coverage/Exposure

Remove a Coverage/Exposure

Please describe the change you are requesting in detail. *

Your answer

Submitting this information IS NOT a Policy or Binder of Insurance. No coverage will be bound until you receive confirmation from us.

BY CLICKING THE "SUBMIT" BUTTON BELOW, I CERTIFY THAT THERE IS NO PRE-EXISTING CLAIM, LOSS OR CIRCUMSTANCE LIKELY TO LEAD TO SUCH A CLAIM OR LOSS FOR WHICH I AM APPLYING FOR COVERAGE.
WARNING: ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND [NY: SUBSTANTIAL] CIVIL PENALTIES. IN TN, VA AND WA, INSURANCE BENEFITS MAY ALSO BE DENIED.
NOTICE TO OHIO APPLICANTS: ANY PERSON WHO, WITH INTENT TO DEFRAUD OR KNOWING HE/SHE IS FACILITATING A FRAUD AGAINST AN INSURER, SUBMITS AN APPLICATION OR FILES A CLAIM CONTAINING A FALSE OR DECEPTIVE STATEMENT IS GUILTY OF INSURANCE FRAUD.

Questions? Contact:
Cameron A. Shandersky, CPCU
Schiff Insurance
P.O. Box 145496
Cincinnati, OH 45250-5496
P: 513.870.2580
cameron_shandersky@schiffinsurance.com

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Cameron A. Shandersky, CPCU
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