Account Info

Update Form

Updating your address, email and phone information is important ...thank you. Also, let us know about changes in your life that might change your insurance needs. Below are a few situations when you should contact us. NOTE: Policy change requests are not binding until confirmed.

Use this form to let us know about changes such as:

  • Change of email, phone numbers or address
  • Purchasing a home or major home renovation
  • Change of garaging of your vehicle
  • Use of your car for business purposes
  • Starting a home based business
  • New student driver in your home
  • New person driving your car on a regular basis
  • Changing jobs
  • Student living at college
  • New person living in your home
  • Marriage or divorce
  • Purchase of a recreational vehicle
  • Death of a spouse or other individual listed on policy 

First Name
Last Name:
Address:
 
City:
State:
Zip:
Home Phone Number:
Business Phone Number:
Preferred method of contact:
 
Cell Phone

Please describe below the changes, additions or deletions to be made to your account.  If the change is specific to a particular policy, please indicate which policy.  Note that policy coverage change requests are not valid until you have received a confirmation from us
    Please be advised that no coverage changes or additions or deletions are effective until received and approved by a member of the Kerrigan, O’Malley & Bailey staff. I understand that not all changes are approved. If you need immediate assistance during normal business hours, it is recommended that you call and speak directly to a staff member.