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Private Client Insurance Review

This confidential intake is reviewed directly by Phil Moroch, Vice President Private Client Group at Wheeler & Taylor.

Please take a few minutes to share details about your property, assets, and coverage. This allows us to complete a tailored review of your current insurance program and identify any gaps in protection.

Let’s Get to Know You

Phone Type *
Preferred Contact Method *
Preferred Contact Time *
Is There A Secondary Insured? *
Phone Type *

Physical Address

Please provide the physical address of the property. This helps us accurately determine your coverage and rating.

Current Carrier *
USD
Primary Residence or Secondary Home? *

Home Safety & Protection Features

Tell us about the safety and protection systems in your home, including fire, security, and prevention features. 

 

Fire Alarm System? *
Who Is It Monitored By? *
Are There Fire Extinguishers? *
Sprinklers? *
Burglar Alarm? *
Who Is It Monitored By? *
Low Temp Alarm *
Automatic Water Shut Off? *
Whole Home Generator? *

Dwelling Details

Please provide details about the dwelling so we can accurately assess the property.

Is It An Historic Home? *
Is The Property Currently Under Construction? *

Collections & Asset Protection

Please provide details about valuable personal property and collections that may require scheduled coverage or enhanced protection.

Do You Have Any High-Value Personal Items That Should Be Scheduled Separately? *
USD
USD
USD
USD

Coverage Details & Property Information

Provide details about your property, coverage selections, and additional features to help us customize your insurance options.

Do You Have Vehicles That Should Be Included In Your Private Client Review? *
USD
Primary Use
USD
Primary Use
USD
Primary Use
USD
Primary Use
USD
Primary Use

Outbuildings & Pool

Any Outbuilding(s)? *
Do You Have A Pool? *
Is It Fenced With A Locking Gate?
Is There A Slide?
Any Diving Board(s)?

Additional Coverage Options

Let us know if you're interested in added protection beyond your home policy so we can review all available options for you.

Do You Currently Carry Umbrella Or Excess Liability Coverage? *
USD
Do You Employ Household Staff? (Nanny, Chef, Housekeeper, Etc.) *
Any Board Memberships / Executive Roles? *
Any Trust Or LLC-Held Assets? *

Additional Properties

Are There Additional Properties Or Assets We Should Include In Your Review? *
Secondary Home *
Vacation Home *
Coastal Property *
Rental / Investment Property *
Condominium / Pied-à-Terre *
Historic Or Landmark Property *
New Construction Or Recently Renovated Home *
Vacant Property *
Land / Undeveloped Property *

Review & Submit

Just one final step to get your quote started.

Please take a moment to review your information before submitting. This helps us ensure your quote is accurate and tailored to your needs.

Initial

0 / 10

Submit Your Request

Thank you for completing this private client intake.

I personally review each submission with a focus on identifying gaps, improving protection, and aligning coverage with the complexity of your assets.

A member of my team or I will follow up directly to discuss next steps.

Best,
Phil Moroch
Vice President, Private Client Services
pmoroch@wheelerandtaylor.com 
d. (413) 300-5175

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