Home/Auto/Umbrella

Over lunch...
Our short presentation will cover some basic but important auto and home coverages, plus some common mistakes you should avoid.

And as an added bonus...
Each person bringing in current auto and homeowners insurance policies for a quote receives a $10 gift card! No purchase
necessary. All staff members are eligible for a substantial MDA group discount and may save a lot of money!

To schedule your Lunch & Learn
Call MDA Insurance at 800-860-2272, ext. 462 to speak with Personal Lines Manager Jeni Drummond or email jdrummond@mdaifg.com. Receive a $20 gift card just for scheduling!

Personal Information

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Home Information:

Auto / Motorcycle / ATV Information:

Vehicle 1

Vehicle 2

Vehicle 3

Year:

Make:

Model:

Vehicle ID VIN:

Principal Driver's Name:

Driver's date of birth:

Driver’s license #:

Number of miles to work:

Comp Coverage Deductible:

Collision Coverage Deductible:

Bodily Injury / Property Damage amt:

Uninsured / underinsured:

Tickets/accidents in last 3 years?

Towing Coverage?

Rental Reimbursement?

Questions? Call MDA Insurance at 800.860.2272.
MDA Insurance | 3657 Okemos Road, Suite 100 | Okemos, MI 48864
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This is not an offer to sell insurance. Insurance coverage cannot be bound or changed via submission of this online form. Note that any proposal of insurance we may present to you will be based upon the values developed and exposures to loss disclosed to us on this online form and/or in communications with us. All coverage is subject to the terms, conditions and exclusions of the actual policy issued.