We value your business and thank you for your confidence in choosing our Brokerage as your insurance representative. As our policyholder, you trust us with your personal information. We respect that trust, and want you to be aware of our commitment to protect the information you share in the course of doing business with us.
How we Collect, Use and Disclose Your Information
When you purchase insurance through our brokerage, you share personal information so that we may provide you with products and services that best meet your needs. We assume your consent for our Companies to use this information in an appropriate manner. We may use and disclose this information in order to:
- Communicate with you
- Access your application for insurance including underwriting and pricing your policies
- Evaluate claims
- Detect and prevent fraud
- Analyze business results
- Act as required or authorized by law
What we will NOT do with Your information
We do not sell customer information to anyone. Nor do we share customer information with organizations outside of our member companies that would use it to contact you about their own products or services.
We Strive to Protect Your Personal Information
All our employees and underwriting Companies who are granted access to customer information understand the need to keep this information protected and confidential. They know they are to use the information only for the purposes intended. This expectation is clearly communicated. We've also established physical and systems safeguards, along with the proper processes, to protect customer information from unauthorized access or use.
Your Privacy Choices
You may withdraw your implied consent at any time in writing, (subject to legal or contractual obligation and on providing us reasonable notice) by contacting our office. Please be aware that withdrawing your consent may prevent us from providing you with the requested product or service. We may occasionally use your personal information to tell you about property and automobile services or products that we believe may be of interest to you.
Privacy Disclosure and Consent
In regards to the insurance contract which I have applied for with the
_________________________ Insurance Company,
I have provided personal information together with this document, and I may in the future provide further personal information. Some of this personal information may include, but is not limited to, my credit information, motor vehicle record and claims history. I authorize my Broker or Insurance Company to collect, use and disclose any of this personal information, subject to the law and to my Broker's or Insurance Company's policy regarding personal information, for the purposes of communicating with me, assessing my application for insurance and underwriting my policies, evaluating claims, detecting and preventing fraud, and analyzing business results. I confirm that all individuals whose personal information is so provided have authorized that I agree to the above on their behalf.
Broker's signature: _________________________________________________