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Become a Hartford Insurance Agent

Thank you for your interest in representing The Hartford for Property and Casualty Insurance. Established in 1810, The Hartford is one of the most recognized and respected insurance companies in the world.

We would like to learn more about you and your agency; therefore, we are requesting you to take a few minutes of your time to complete the form below.

Once received by our New Appointment Team, one of our New Appointment Specialists will contact you to further discuss details of your agency operation, continue with the data collection and provide information to you about The Hartford. This information will help ensure a smooth and expedited process to better understand each other's capabilities and expectations.  This will establish a sound baseline, enabling us to decide whether we proceed to mutually making commitments to develop a strong and profitable partnership.

If you prefer to speak with one of our New Appointment Consultants, please call 1-877-853-2582, Ext. (5601) between 8-5pm EST and we will be happy to begin the process over the telephone.

We look forward to putting our strength to work for you.

Agency Information Questionnaire
Agency Name:
Street Address:
City:
State:
Zip Code:
Phone Number: (XXX-XXX-XXXX)
Fax Number: (XXX-XXX-XXXX)
Key Contact:
Title:
Email Address: (name@domain.com)
Web Address: (www.yourco.com)
Years in Business:
Year of Present Ownership:
Number of Licensed Producers:
Number of Licensed CSRs:
What is your agency's total written premium?
What is the percentage of written premium for personal lines and commercial lines?
Personal Lines:
%
Commercial Lines:
%

Personal Insurance
Personal Lines Total Premium:
Please list your top 3 Personal Insurance Carries by total written premium volume:
1.
 $ 
2.
 $ 
3.
 $ 

Monthly New Quote Flow:
Issue Rate:

Commercial Insurance
Commerical Lines Total Premium:
Please list your top 3 Commercial Insurance Carries by total written premium volume:
1.
 $ 
2.
 $ 
3.
 $ 

Monthly New Quote Flow:
Issue Rate:

Comments/Questions

PDF Version

If you would rather fax in the form, download this form, fill it out and fax it to 877-905-1766.

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