New Program Configuration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to A.I. Insurance! To get you started, we need some information to help us get you up and running on our platform.

What company name would you like to see in AI Insurance? *

What’s the legal name of the above insurance company or program?
*

This would be the name that you want to see on a COI

What is the URL of your company's website?

If applicable

Insurance Company Address

The address on your COI's (optional)

Lines of Coverage
*

What lines of business will you be writing once you go live?

Covered Entities

What sort of entities will you be insuring? Trucking companies? Healthcare providers? Construction sites, etc. This is anything that might be listed in a "Schedule" on the policy

Your email address
*

We'll reach out to schedule an intro call

Do you want AI Insurance Consulting Services involved in your setup?

At no additional cost, AI Insurance can advise you on best practices for modifying your forms or your underwriting. Changing to fit our recommendations will significantly improve your operational efficiency long term, but sometimes causes friction internally (change is tough) so we like to get buy-in now.

Please notify me of when/how to change my forms or underwriting to better fit best practices

Match my current forms and underwriting as closely as you can, we want to change as little as possible

Clear selection

Desired "Go Live" Date
*

YYYY

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of A.I. Insurance. Report Abuse

Forms