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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].

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

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

It saves you money to have an email address on file.

If we don't know your number we can't contact you.

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. Feel free to reach out via text for quicker and easier assistance!

Day 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 additional drivers names, driver's license number, date of birth

Include Year Make Model VIN

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?

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 drive daily.

Is the vehicle financed
Yes
No

Legally if you have a loan on a vehicle we have to notate that and send the proper documents to your finance company.

Legally if you have a loan on a vehicle we have to notate that and send the proper documents to your finance company.

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?

Some carries do not report to the insurance databases. Some carriers give you significant discounts based on how long you've been continuously insured.

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?

 

© 2025 by Rick The Insurance Guy

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