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Apply for Auto Insurance online


Once you have received your quote number, complete the following application to buy car insurance online and order instant proof:

Agreement to Apply For and/or Purchase Automobile Insurance Electronically
Instead of going to my insurance agent’s or broker’s office in person, I want to apply for and potentially purchase automobile insurance online by using the EZBuy web site. I have made this decision to apply for and potentially purchase insurance using the EZBuy website at my sole discretion and I have not been influenced by the agent or broker or its representatives in making this choice. In order to apply for insurance on line, instead of reviewing printed disclosures, applications, agreements and signing my name to pieces of paper, I will be reading those disclosures, applications and agreements on the EZBuy website and clicking on buttons that say "Accept" or "I Agree." Every time I click on a button that says "Accept" or "I Agree, " I intend that click to be my "electronic signature" and to have the same effect as if I had actually handwritten my signature on a piece of paper. I understand that in order to initiate future changes to my policy I may be required to submit a written request with my actual signature.

I Agree;

Consent to Receive Consumer Disclosures Electronically
I Agree As a part of every automobile insurance application, you are entitled to receive certain consumer notices and disclosures. Usually, those notices and disclosures are on pieces of paper that you are given out at your insurance(agent) 's or broker’s office when you apply for insurance. You can use the EZBuy internet insurance application process instead of applying in person at agent’s or broker’s office, if you agree that any required consumer notices and disclosures can be given to you through the internet during and after the completion of the application process on line. If you change your mind at any time during this process, you can simply close your Internet session, go to the agent’s or broker's office and apply in person. Your consent to receive consumer notices over the Internet is effective only for this one on line insurance application. If you want a paper copy of any of the consumer notices, simply click File, Print, and print the consumer notice to the printer attached to your computer. If you want to see a copy of these consumer notices or any other portion of your on line application after your application has been submitted, simply log back on to with the quote number and zip code that you just used to begin this session and you will be able to review and print your completed EZBuy application and documents. Your entire application, including any consumer notices will remain available to you in this manner for the next 12 months. You can also request that the agent or broker give you a paper copy of your entire application by calling the agent or broker directly or mailing a written request to their address. To use this on line insurance application process, you need a computer connected to the Internet with the following minimum specifications: -Windows(2000 Or XP) -Microsoft Internet Explorer version 6 or higher with 128 bit encryption -Apple Macintosh version OS X or higher -Safari version 1.2 or higher with 128 bit encryption If you can view this page, your computer equipment is sufficient to use the EZBuy on line insurance application process and receive any required consumer disclosures. I CONSENT TO RECEIVE ANY REQUIRED CONSUMER NOTICES RELATED TO MY AUTOMOBILE INSURANCE APPLICAION ELECTRONICALLY DURING THE ON LINE APPLICATION PROCESS.
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