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Personal Auto Quote Request

Disclaimer


By submitting this form, you agree to be contacted by Gilliland Insurance and its subsidiary Rick the Insurance Guy regarding your insurance inquiry. Rick Gilliland, owner and founder of Gilliland Insurance and Rick the Insurance Guy, will be the only person to contact you. Completing this form does not guarantee coverage or bind any insurance policy. All quotes are subject to underwriting approval and may require additional information. We respect your privacy and will never share your information without your consent. For full details, please see our [Privacy Policy] and [Terms & Conditions].


We understand that some questions on the intake form make you ask "why do you need to know that?" To ease any anxiety, we provide clear explanations along the way, helping you understand how each question contributes to offering more affordable insurance prices. Your privacy is important to us, and we’re committed to being transparent throughout the process.  Below we have provided very important details about the information requested and answers for why each piece of information is important to the price you pay for your insurance as well as how your information is safeguarded to keep your information secure, and private.

This is important because your legal name helps accurately match for better rates.

Rick understands sometimes you prefer a different name, I have a cousin that everybody calls Chilly!

Even if you got married, but you haven't changed your information at the DMV.

We don't sell your information, and Rick is the least pushy salesperson you'll ever meet. I'm not gonna bombard you with daily contacts. PLUS it saves you money to have an email address on file.

If we don't know your number we can't contact you. Rick does not do initial contact via email for privacy and security purposes.

Do you prefer phone call or text?
Call Me
Text Me

At Rick the Insurance Guy, we understand that phone calls can be difficult during your busy day. That's why we offer texting as a convenient and viable form of communication (carrier pigeons still in training). Feel free to reach out via text for quicker and easier assistance!

Date you were born
Month
Day
Year

Current Legal Address

(If you recently moved please let us know)

Legal Address (With the DMV)
How long at your address?
1 Year or less
1-3 years
3-5 Years
5 Years or more

Believe it or not insurance carriers communicate with the DMV, if this doesn't match this can lead to you paying far more in premiums if it's not accurate.

Do you own or rent your home?

This is important not for us to upselI you and talk you into bundling but because it can change your premium by up to 25% based on the carrier. If your name is not on the mortgage, deed, lease, or rental agreement then "Other" is the choice for you.

You DO NOT have to provide this information for you to receive a quote if you do not wish; however, providing this information often results in much less expensive quotes.

We don't need to know where you work, just the industry you are in, some carriers even give discounts for servers, and cashiers.

Gender Assigned at Birth
Male
Female

We understand this is a sensitive topic, and we will respect you no matter what. However, insurance premiums are set by the carriers, and legally we still have to know your gender assigned at birth.

Please include the names, driver's license numbers, and dates of birth for any additional drivers. If you do not include all information it may lead to delays in your quote request.

Just a heads-up, in most states, if you're married and your spouse is on the vehicle title, or doesn’t have their own insurance, they usually need to be listed on your policy. We can mark them as a non-driver if needed, but leaving them off completely can cause problems.

Insurance companies often get alerts about "unlisted drivers," and may automatically add them, which can raise your premium. Your agent can’t stop this unless we have proof, like their separate insurance policy.

Rick, your agent, can only go by the info you give him. While listing fewer people might make your rate seem cheaper at first, the DMV and the insurance company will eventually catch up to any missing info. That’s often why people see big price jumps at renewal time.

Include Year Make Model VIN. The more vehicles you include on one policy, the lower the cost tends to be per car often by more than 50%. If you're being told otherwise, it's worth getting a second opinion, as that information may not be accurate or in your best interest. (In simple terms, those other agents are lying to you).

How many years have you been licensed
Less than 1 year
1 - 3 years
3-5 years
More than 5 years

The DMV will match this to you in the end. The difference is it helps us find the right carrier. Some carriers just won't issue a policy if you haven't been licensed a certain length of time.

Do any of the following apply for you or any other drivers for your policy in the last 5 years? Check every box that applies to you.

The DMV will match this to you in the end. Some carriers have strict requirements and this information just helps us find the right one for you.

Starting a policy the same day you pay for the policy can make your premium go up as much as 15% with some carriers. Starting it a week from the day you pay can often help your premium be lower.

Primary use of vehicle

Carriers charge more for usage purpose of some vehicles. Why? The risk of you having a total loss on a garage kept vehicle that you drive twice a year is far less than the grocery getter, and soccer mom taxi you might drive daily.

Do you ever use your vehicle for ridesharing?
Yes
No

Uber/Lyft/Door Dash/Turo/Grubhub/Other Ride Share

Is the vehicle financed
Yes
No

If your vehicle is financed, we’re required to note that and send the necessary documents to your finance company. Please also keep in mind: if there’s a lien on your vehicle and you don’t carry the insurance your lender requires, they do have the legal right to add insurance coverage on your behalf and include the cost in your loan payments.

We don't want to quote you with the same company you already are dissatisfied with.

How many years have you had your policy with your current carrier?
Less than 1 year
1 year to 3 years
5 years or more
Never had insurance in my name
My policy lapsed (this is not a dealbreaker Rick writes policies for individuals with a lapse in coverage)
Liability Coverage Amount Desired
$25,000/$50,000/$25,000 (South Carolina State Minimum)
$50,000/$100,000/$50,000
$100,000/$300,000/$100,000
Other Coverage Amount

Many people don't understand this portion so this is a very simple explanation:


Auto insurance liability amounts are the limits of how much your insurance will pay if you're at fault in an accident.


For example, if your coverage is 25/50/25, it means:

  • $25,000 for one person's medical bills,

  • $50,000 for everyone’s medical bills in the accident,

  • $25,000 to fix their car or property.

If the damage costs more than your limit, you may have to pay the difference.


Other Coverages

If you are new to ride sharing like Uber, Lyft, Turo, Getaround, DoorDash, etc. and they have requested proof of your Ride Share Endorsement let us know, and we will make it less scary.

Do you need any additional coverages?
Do you need a SR-22?
Yes
No

An SR-22 in South Carolina is not a type of insurance, but a special form your car insurance company sends to the state to prove that you have the required car insurance.

It’s usually required if you’ve had a serious driving issue like a DUI, driving without insurance, or too many tickets. The SR-22 lets the state know you're properly insured now. If your insurance ever gets canceled or ends, your insurance company must tell the state right away, which could get your license suspended again.

 

© 2026 by Rick The Insurance Guy © 2026 Gilliland Insurance © 2026 Gilliland Services

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