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Kistler Financial Insurance Group®, Inc. offers a variety of vehicle insurance and service options to meet the needs of lending institutions. Whether you need to force-place coverage on your collateralized loans or find out how to conveniently and cost-effectively cover all the loans in your portfolio, Kistler has the product for you. Please fill out the questionnaire below. If you prefer, you may print this form and fax it to (770) 394-8112.

For more information, contact Sales and Service:
Ph. (800) 962-6888 or Email

Comprehensive Vehicle Coverage Questionnaire
(for recreational and licensed-for-road-use vehicles and non-commercial watercraft)

The form failed to submit. Please confirm that all required fields have been completed.

*Lender's Name:
*Contact:
*Address 1:
Address 2:
*City:
*State:
*Zip Code:
*Phone Number:
*Number of branches:

How did you hear about us?
Referral
Web
Word-of-mouth
Trade show/conference, if so, which one?
Other:

*We are interested in learning about insurance that will protect us, the lender, when our borrowers let their insurance lapse on the collateral indicated below:
Private passenger autos, vans, pickups and trucks to one-ton load capacity
Trucks in excess of one-ton load capacity
Motorcycles
Recreational vehicles, such as campers and motor homes
Watercraft (non-commercial)

*What type(s) of coverage are you interested in for each individual loan?
Blanket portfolio coverage
Force- or creditor-placed coverage (individual policies on specific collateral)
Both

*With coverage including:
All risk physical damage
Instrument non-filing vehicle coverage
Skip and confiscation coverage
Repossessed collateral physical damage
Waiver of actual cash value/GAP (Guaranteed Auto Protection)

Please tell us about your loan history and future forecasting.

*Total number of vehicle/boat loans currently open:
*Number of New:
*Number of Used:

*Percentage of Direct: %
*Number of New:
*Number of Used:

*Percentage of Indirect: %
*Number of New:
*Number of Used:

Dollar amount of outstanding for:
*Direct:  $
*Indirect:  $

*What is the total number of vehicle/boat loans that you expect to make in next 12 months?
*Number of New:
*Number of Used:
*Percentage of Direct: %
*Percentage of Indirect: %

*Average number of months in an original loan term for new vehicles:
*Dollar Amount: $

*The average number of months in a payout for new vehicles is:

*Average number of months in an original loan term for used vehicles:
Dollar Amount: $

*The average number of months in a payout for used vehicles is:

Average percentage of MSRP (Manufacturer's Suggested Retail Price) financed:
*Percentage of New: %
Percentage of Used: %

*Do you wish to cover dealer originated loans? Yes No
(If yes, provide details of recourse agreements, if any )


*Do your loan agreements require physical damage insurance naming you loss payee? Yes No

Do your loan agreements disclose that you, the lender, have the right to purchase physical damage coverage and add the cost of that coverage to the borrower's loan payment, if the borrower does not purchase his/her own physical damage coverage?
Yes No

Please summarize your insurance follow-up program:


What specific action(s) do you take when you receive notice of cancellation or expiration of a borrower's insurance policy?

Number of repossessions?
*YTD:
*Last Year:
*Prior Year:

How many were damaged?
*YTD:
*Last Year:
*Prior Year:

Number of physical damage claims filed with current insurance provider?
*YTD:
*Last Year:
*Prior Year:

Dollar amount of physical damage claims paid by current insurance provider?
YTD:		$
Last Year:		$

Number of recovered skip losses last year?
*YTD:			Dollar Amt: $
*Last Year:			Dollar Amt: $
*Prior Year:			Dollar Amt: $

*Do you currently have a blanket or force- or creditor-placed insurance program? Yes No

*Under your current policy, what was your premium for coverage for the last 12 months? $

*Have you ever had a blanket or force- or creditor-placed insurance program? Yes No
(If yes, please state when it was canceled, by whom and why. )


*Do you make loans under lending guidelines that would be considered sub-prime, or "C&D" paper loans? Yes No

*Assumption of coverage on existing loans: Do you want this coverage to be extended to loans made or acquired prior to the effective date of this policy? Yes No

Please indicate your current provider's insurance rate:

Remarks:

  

8050 Roswell Road, NW . Atlanta, Georgia 30350-3928 . Phone: 800-962-6888 . Fax: 770-394-8112 . PRIVACY POLICY . Copyright © 2009