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Policy Change Request


PLEASE READ FIRST!
Because it is our responsibility to make sure that you're covered, we can't make changes to your policy until we have communicated directly with you. To ensure that your policy change is effective immediately, please login to your insurance carrier under the payment/policy change tab. If you can't login to your insurance carriers website for whatever reason, please submit the simple form below. Add the specific information (VIN, year, make, and model, DLN, which car to be replaced, etc) in the notes section. We will contact you to verify the changes before the change can be submitted. 


First Name
Required
Last Name
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
Policy #
Optional
Type of policy:
Optional
Type of change:
Optional
Notes:
Optional
Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
   

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325 W. County Line Rd. | Greenwood, IN 46142

Phone: 317.865.1000 | Fax: 317.865.7772 | Email:
bandyins@gmail.com
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