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Complete Review

Your Risks, Covered

A great opportunity to assess coverage.

There’s one guarantee in life and business. Things change. Our annual review is an opportunity to compare your existing coverage against your current needs to ensure your insurance remains appropriate to your situation.

Complete Annual Review

Complete Annual Review

Step 1 of 9

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This field is for validation purposes and should be left unchanged.
Client Information
Primary Contact Name
First Name Last Name
What type(s) of insurance do you currently have with us?
- Personal Insurance
- Commerical Insurance
- Employee Benefits
- Specialty Insurance
Home Address
Street Address Address Line 2 City State ZIP Code
Company Name
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Total Annual Sales
Total Annual Sales
Total Number of Employees
Total Number of Employees
Phone Number
Phone Number
Email Address
Email Address

Your Home(s)
Please think back over the last year when answering these questions.
Have you remodeled or made any major updates to an existing home(s)?
- Yes
- No
(New roof, furnace, or electrical system)
Have you added a home security system?
- Yes
- No
Have you started a home-based business?
- Yes
- No
Have you purchased a secondary residence, including a condo or timeshare?
- Yes
- No
Have you started participating as a service provider in the home sharing economy?
- Yes
- No
(Airbnb, VRBO)
Please explain any changes to your home.
Please explain any changes to your home.

Your Automobiles and other “Vehicles”
Please think back over the last year when answering these questions.
Have you added an automobile, watercraft, or recreational vehicle?
- Yes
- No
Have you added any new drivers?
- Yes
- No
Have you added a vehicle provided by an employer?
- Yes
- No
Have you had a child leave home to attend school or no longer considered a dependent?
- Yes
- No
Have you started participating as a service provider in the ridesharing economy?
- Yes
- No
(Uber, Lyft, Sidecar)
Please explain any changes to your automobiles and "other" vehicles.
Please explain any changes to your automobiles and "other" vehicles.

Your Other Life Events
Please think back over the last year when answering these questions.
Have you added or changed ownership of any assets including titles, trusts or LLCs?
- Yes
- No
Have you hired domestic help, nanny or housekeeper, either full or part-time?
- Yes
- No
Have you purchased jewelry, art or other valuables that need to be added? Are there items that need to be changed or deleted?
- Yes
- No
Have you had a significant change in net worth?
- Yes
- No
Have you accepted a position on a board(s) of a profit or nonprofit organization(s)?
- Yes
- No
Please explain any changes.
Please explain any changes.

Your Business Structure
Please think back over the last year when answering these questions.
Have you changed the ownership structure of your business?
- Yes
- No
Have you added new or changed your existing operations and/or products?
- Yes
- No
Have you begun to buy supplies or sell your products overseas?
- Yes
- No
Are you operating out of any new locations or have you closed locations?
- Yes
- No
Please explain any changes to your business structure.
Please explain any changes to your business structure.

Your Personal Liability
Please think back over the last year when answering these questions.
Have you acquired, leased or sold a building, business property and/or equipment?
- Yes
- No
Have there been any improvements and/or significant alterations to your building?
- Yes
- No
Has your Inventory level changed significantly?
- Yes
- No
Have you purchased, leased or sold any Vehicles?
- Yes
- No
Please explain any changes to your personal liability.
Please explain any changes to your personal liability.

Your Income Protection
Please think back over the last year when answering these questions.
Have your Businesses revenues changed by more than 10% since last year?
- Yes
- No
Do you rely on a single supplier for more than 50% of your materials?
- Yes
- No
Do you rely on a single buyer for more than 50% of your sales?
- Yes
- No
Please explain any changes to your income protection.
Please explain any changes to your income protection.

Your Employees & Professional Liability Exposure
Please think back over the last year when answering these questions.
Do you have employees that regularly travel out of state or overseas for business?
- Yes
- No
Do any employees use their own personal cars for business purposes?
- Yes
- No
Do any Employees work outside your home state or work from their home regularly?
- Yes
- No
Do you obtain Certificate of Insurance from all subcontractors, vendors and 1099 workers?
- Yes
- No
Are any of the owners a member of any board of directors whether for profit or not?
- Yes
- No
Please explain any changes to your employees and personal liability exposure.
Please explain any changes to your employees and personal liability exposure.

Additional Protection
Dansig Insurance Risk Advisorsis a full service agency providing solutions for personal, business, employee benefits and specialty Insurance needs for our clients.
Would you like to discuss any additional insurance protection with our firm?
- Yes
- No
Confirmation
Your initials
Your initials

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Taylorville, IL Office

Shelbyville, IL Office

Macomb, IL Office

Arthur, IL Office

Eagleville, TN Office

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800-429-5495

(Monday - Friday, 8am - 5pm)

Our Locations

Decatur, IL Office
Taylorville, IL Office
Shelbyville, IL Office
Macomb, IL Office
Arthur, IL Office
Eagleville, TN Office

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About Dansig Insurance Risk Advisors

We’re independent insurance risk advisors offering a thorough suite of insurance solutions to protect your business and your life from the unexpected.

Areas served: Dansig Insurance Risk Advisors is your trusted advisor serving clients in Decatur, IL, Taylorville, IL, Shelbyville, IL, Macomb, IL, Springfield, IL, Champaign, IL , and across the United States - offering personal, commercial, home and car insurance, and employee benefits products and services.

We don’t just sell insurance. We work closely with clients to help them make important and informed decisions every day when it comes to protection and their future.

We Are

Risk Advisors
Consultative
Diagnostic
Results Driven
Focused on Mitigating Risk

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About
RiskLock
Personal
Commercial
- Human Resource Assets
Benefits
- The Advantages of Self-Funding
Specialty
Contact
Get Quote

Amazing Feedback
Client Portal
Clickable Coverage®
Blog
Call 800-429-5495

Visit Dansig Insurance Risk Advisors on Twitter
Visit Dansig Insurance Risk Advisors on Facebook
Visit Dansig Insurance Risk Advisors on Linkedin

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Dansig Insurance Risk Advisors is pleased to celebrate our 50th anniversary in 2022. Learn more about the difference that comes with experience.

Dansig Insurance Risk Advisors is pleased to celebrate our 50th anniversary in 2022. Learn more about the difference that comes with experience.

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