STR Insure - Applicant Information
Note that you will have a chance to review and revise all of this information prior to securing an insurance policy, though accuracy helps in getting quote prices. Would you rather get us this information over the phone? No problem, give us a call at (855) 578-7467. We can also get you quotes on autos, umbrellas, RVs, ATVs, motorcycles, flood and more if you give us a call.

This process will take approximately 5 minutes.  Your responses will remain confidential by STR Insure.

We are currently licensed in Arizona, Colorado, Minnesota, Oregon, and Texas, but will be expanding to other states. If you have a home in another state and would like to be notified when we are licensed in that state, please provide your contact information and the address of the property.
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Email *
First Name *
Last Name *
Phone *
Occupation
Address of property to insure *
City *
State *
Please spell out the name of the state
Zip *
Mailing Address
Mailing address (If different than property address to be insured)
Mailing City
Mailing State
Mailing Zip
Description of your home uses
Uses and characteristics of property, check all that apply
Advertising Link
(If applicable, please provide your AirBnB or VRBO link - this helps us make sure we have the replacement cost estimation as accurate as possible)
Current Carrier
If property is currently insured, name of current insurance carrier.
Current Premium Amount
Policy annual payment
Effective Date
Date you want this policy to start.
MM
/
DD
/
YYYY
Principal First Name
First named insured, please include first name of the individual or the name of the entity or trust to be listed on the policy.
Principal Last Name
First named insured, please include last name of the individual or the remaining portion of the name of the entity or trust to be listed on the policy.
Principal Birthday *
Date of birth of the first named insured or the first individual with control of the entity or trust.
MM
/
DD
/
YYYY
Second Named Insured First Name
 If there a 2nd person or entity that should be listed on the insurance policy enter their first name.
Second Named Insured Last Name
Last name of the second named insured.
Second Named Insured Birthday
Date of birth of the first named insured or the first individual with control of the entity or trust.
MM
/
DD
/
YYYY
Second Named Insured Occupation
Number of Mortgages on the Property
Updates: Roof
What year was the roof last replaced?
Updates: Electrical
What year was the electrical installed (or if updated, what year was it updated)?
Updates: Heating
What year was the heating system installed (or if updated, what year was it updated)?
Updates: Plumbing
What year was the plumbing system installed (or if updated, what year was it updated)?
Potential Discounts
Dwelling Limit
Dwelling coverage limit desired (anticipated), this is the cost to rebuild the home or condo in the event of a total loss (estimate is fine, we can review & research further). Note this need to be at least  80% of the  actual cost if the home needs to be  fully rebuilt or policy overages will be reduced.  
Personal Property Limit
Short-term rental business and personal contents coverage.  This is the anticipated cost to replace all of the items inside the property such as furniture, bedding, supplies kept onsite, linens, refrigerator, tools, knick knacks, etc.
Loss Of Use Limit
Business income limit (loss of rents) coverage.  For example rental income amount ($) per month x 12 = loss of rents. Income for previous year can be used to estimate.
Other Structures Limit
Separate structure(s) coverage limit.  This coverage is for separate structures and elements detached from the home. For example an accessory dwelling, patio, fence, detached garage, barn, carport, hot tub, swimming pool, etc.
Medical Payments Limit
Medical payments, this coverage can be used if a guest is injured on your property to pay for medical costs and no proof of fault is required. This coverage may help to mitigate lawsuits if used proactively.
Personal Liability Limit
Liability coverage requested (most city short term rental ordinances require ~$500,000)
Desired Deductible
Policy deductible amount desired
Water Sewer Back Up
Water sewer back up and sump pump coverage requested:
Extended Replacement
Extended replacement cost for dwelling? This recommended coverage will help protect policyholders from an inflation in the reconstruction costs after a major disaster.
Claims: Details
Please briefly describe all the insurance claims you have had at this or any other location in the last 5 years? What caused the loss and what was done to remedy the issue?
Claims: Date
What date did the loss occur?
Claims: Amount Paid
What amount did the insurance company pay for this claim?
Referral Source
How did you hear about STR Insure?
Additional Quotes or Endorsements
Other types of insurance quotes or endorsements you would be interested in, check all that apply.
Change Desires
What are you seeking in changing to a new insurance company/policy?
Additional Questions
Do you have any questions or anything else we should know relative to your STR or desired insurance coverage?
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