Auto Insurance Quote Form
An auto insurance quote form asks the handful of things that actually move a premium: the vehicle, who drives it, how far, where it's kept, and what's happened before.
For brokers, agents and insurance teams.
Claims and convictions, asked plainly
The two answers that change a motor premium most are the two people most want to skip. Nobody enjoys typing out last year's bump, and a form that buries the question gets non-disclosure - which voids cover exactly when it's needed.
So this template asks about claims and convictions directly, with a plain note explaining that non-disclosure can invalidate a policy. People answer honestly when the reason is visible, and an honest answer is worth more to both sides than a cheap quote that won't pay out.
Quote faster than the person they emailed second
Most clients ask two or three businesses at once, and the first useful reply usually wins. What slows you down is rarely the pricing - it's not knowing enough to price it.
This template asks the handful of things that decide the number, so the first thing you send can be a real quote instead of a request for more detail.
Enough detail to quote, not enough to be a nuisance
Quoting needs specifics - cover type, value, dates, claims history - and every extra question loses people. The answer is to ask the ones that change the premium and nothing else, in one short pass.
Claims and renewals work the same way: ask the facts that let you act, keep it short enough that a stressed client finishes it, and have it in writing from the start.
One link, on every channel
Put it behind "Get a quote" on your site, in your email signature, in your Google Business profile and on a card. Same form, one place the answers land, no lead lost because it arrived at the wrong inbox.
Yours to change, immediately
Nothing here is fixed. Rewrite a question, reorder them by dragging, add your brand colour, delete half of it. Save and the live form updates - there's no separate publish step and no deploy to wait for.
What this template asks
- Your name
- Email address
- Phone number
- Date of birth
- Postcode where the car is kept overnight
- Registration
- Make and model
- Year of manufacture
- Approximate value
- Where is it kept overnight?
- Any modifications?
- How is it used?
- Annual mileage
- How many additional drivers?
- Age of the youngest driver
- How long has the main driver held a licence?
- Claims or accidents in the last 5 years?
- Tell us what happened, and when
- Motoring convictions in the last 5 years?
- Years of no-claims discount
- What cover would you like?
- When would you like cover to start?
- Any extras?
More Insurance forms
Questions
How much detail do we need for a quote?
Enough to rate it: vehicle, drivers, use, mileage, overnight location, claims and convictions. Everything else can wait until the customer wants to proceed.
Should we ask for the registration?
Yes - it's the fastest way to identify the vehicle accurately, and customers know it. Automatic lookups aren't built into the form, so treat it as the customer's own answer.
Can I ask for photos or files?
Not yet - uploads are on the roadmap. In the meantime, most people ask for a link to photos, or reply to the response with an email asking for them. Everything else about the job is captured here.
Can I see where each quote request came from?
Yes. Add a hidden tracking parameter to the link (for example one link on your site and another on your Google profile) and it's stored with the response.
How fast can I put this live?
About a minute. Pick the template, change the wording, press save - saving is publishing - and you get a link to share.
Is it suitable for claims information?
For dates, descriptions and contact details, yes, and the timestamped record is useful. Don't collect full bank details or identity documents through a web form; ask for those through a channel designed for it.
Publish your auto insurance quote form today
Start from this template and change anything you like. Free to begin.