Add a Driver or Vehicle Please enable JavaScript in your browser to complete this form.Personal Information - Step 1 of 5 Personal Information First Name *Last Name *Email *Policy Number *NextAdd a Driver *NoYes Driver First Name *Last Name *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Driver's License Number *Years Licensed *Gender *MaleFemaleOtherOccupation *Marital Status *SingleMarriedResidence Status *HomeownerRenterOtherPrior DUI *NoYesAny claims or tickets in the last three (3) years? *NoYesNot SurePreviousNext Vehicle Add a Vehicle *NoYesName of Primary Driver *[icon name="question-circle"]Because you are not adding a new driver, the Primary Driver for this vehicle must be someone who is already on your existing Auto Insurance policy.Year *Make *Model *VIN Number *Current Mileage *Yearly Mileage *Towing Coverage *NoneYesRental Reimbursement *None$30 Per Day/30 Days$50 Per Day/30 Days$75 Per Day/30 DaysPreviousNext Coverages This page will only be displayed if you are adding a vehicle. Please continue to the next page. What kind of coverage are you looking for? *Full Coverage With QuoteHaven's Minimum LimitsFull Coverage With Custom LimitsLiability Only With State Minimum LimitsLiability Only With Custom LimitsNot Sure[icon name="question-circle"]Full Coverage provides coverage for your vehicle repairs, the third-party's medical bills, and the third-party's property damage regardless of who was at-fault. Liability Only provides coverage for the third-party's bills, but does not cover the cost of your vehicle repairs. Liability Limits for Bodily Injury and Property Damage *$15,000/$30,000/$5,000 (State Minimum in CA)$15,000/$30,000/$10,000$25,000/$50,000/$25,000$50,000/$100,000/$50,000 (Recommended Minimum)$100,000/$300,000/$50,000$100,000/$300,000/$100,000$250,000/$500,000/$100,000$250,000/$500,000/$250,000$100,000 Combined Limit$300,000 Combined Limit$500,000 Combined Limit[icon name="question-circle"]This coverage protects you by paying the third-party's medical expenses and property damages when you are at-fault. This insurance is mandatory by state law. (Maximum Payout Per Person / Maximum Payout Per Accident / Property Coverage)Liability Limits for Bodily Injury and Property Damage *$50,000/$100,000/$50,000 (Recommended Minimum)[icon name="question-circle"]This coverage protects you by paying the third-party's medical expenses and property damages when you are at-fault. This insurance is mandatory by state law. (Maximum Payout Per Person / Maximum Payout Per Accident / Property Coverage)Liability Limits for Bodily Injury and Property Damage *$15,000/$30,000/$5,000 (State Minimum in CA)[icon name="question-circle"]This coverage protects you by paying the third-party's medical expenses and property damages when you are at-fault. This insurance is mandatory by state law. (Maximum Payout Per Person / Maximum Payout Per Accident / Property Coverage)Medical Payments *None$500$1,000$2,000$5,000$10,000$25,000[icon name="question-circle"]This coverage helps pay minor medical expenses of any passenger in the insured's car after an accident; such as transportation to the hospital. Can be used regardless of who was at fault. This is not a replacement for a proper Health Insurance policy. Liability Limits this low are a cheaper option, but not recommended. Medical expenses and vehicle repair costs rack up quickly; you may not have enough insurance to cover it! Refer to your state's insurance guidelines to find out what the minimum limits are. QuoteHaven's Minimum Limits provide you reasonable coverage without overpaying. These Liability limits are a great starting point, however, higher limits are always recommended. These Liability Limits are a great starting point, however, higher limits are always recommended. This is an exceptional amount of Liability coverage. Higher limits are always recommended, so consider Umbrella Insurance if it's within your budget, or you have assets to protect. Personal Limits for Uninsured Motorist Bodily Injury *None$15,000/$30,000$25,000/$50,000$50,000/$100,000 (Recommended Minimum)$100,000/$300,000$250,000/$500,000$300,000 Combined Limit$500,000 Combined Limit[icon name="question-circle"]This coverage provides you, your family members, and passengers coverage for medical expenses when you are involved in a not-at-fault accident, and the third-party does not have Auto Insurance. (Maximum Payout Per Person / Maximum Payout Per Accident)Personal Limits for Uninsured Motorist Bodily Injury *$50,000/$100,000 (Recommended Minimum)[icon name="question-circle"]This coverage provides you, your family members, and passengers coverage for medical expenses when you are involved in a not-at-fault accident, and the third-party does not have Auto Insurance. (Maximum Payout Per Person / Maximum Payout Per Accident)Personal Limits for Uninsured Motorist Bodily Injury *None$15,000/$30,000[icon name="question-circle"]This coverage provides you, your family members, and passengers coverage for medical expenses when you are involved in a not-at-fault accident, and the third-party does not have Auto Insurance. (Maximum Payout Per Person / Maximum Payout Per Accident)Personal Limits for Uninsured Motorist Property Damage *Full Compensation for Vehicle Repairs[icon name="question-circle"]This covers the cost of your vehicle repairs when you are involved in a not-at-fault accident, and the third-party does not have Auto Insurance. With Full Coverage, if you are partially at-fault, your insurance company may require a deductible payment before covering any costs. Personal Limits for Uninsured Motorist Property Damage *$3,500[icon name="question-circle"]This covers the cost of your vehicle repairs when you are involved in a not-at-fault accident, and the third-party does not have Auto Insurance. Comprehensive/Collision Deductibles *$100/$100$100/$250$100/$500$100/$1,000$250/$100$250/$250$250/$500$250/$1,000$500/$100$500/$250$500/$500$500/$1,000$1,000/$100$1,000/$250$1,000/$500$1,000/$1,000[icon name="question-circle"]Comprehensive and Collision Coverage is what covers the cost of your vehicle repairs after an accident, while deductibles are what you pay to the insurance company to access this coverage. Lower deductibles increase your monthly rates, while higher deductibles decrease your monthly rates. PreviousNext Effective Date Effective Date *As Soon As PossibleFuture DateFuture Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 By submitting this form you understand that changes to policies via this website are not effective or binding until you or any party involved receive official notification from your insurance agent or insurance company. PreviousEmailSubmit