Coverage Targets & Current Policy — Update / setup form (auth-only) for Insurance. Standalone version — a hosted mini landing page (an embeddable twin is also available).

The coverage you want and how your current policy is set up, so we can quote it accurately.

What it collects (by section):

• Coverage targets — Primary Liability Limit Target [dropdown: $300k / $500k / $1M / $2M / $5M / …]; Umbrella/Excess Limit Target [dropdown: None / $1M / $2M / $5M / $10M / …]; Primary Deductible Preference [dropdown: $500 / $1k / $2.5k / $5k / $10k / …]; Coverage Enhancements Sought [multi-select: Replacement cost / Business income/extra expense / Hired & Non-Owned Auto / Cyber add-on / Flood / …].
• Your current policy — Current Policy Number(s) (optional) [short text]; Current Premium (annual est.) [number]; Prior Coverage Lapse (36 mo.) [dropdown: No / Yes - <30 days / Yes - <30 days / Unknown]; Remarketing Permission (renewal) [choice: Yes / No / Case-by-case]. Where things stand today — references only, never account numbers.
• Billing & payment — Billing Plan Preference [dropdown: Paid in full / Semi-annual / Quarterly / Monthly / Agency bill / …]; Payment Method Preference (insurance) [dropdown: ACH / Credit/Debit card / Check / Employer deduction / Other].
• Certificates & additional insureds — Certificates of Insurance Needed [choice: Yes / No / Possibly later]; COI Holder List (names/emails) [long text]; Additional Insureds Required [choice: Yes / No / Unsure]; Additional Insured Names [long text]; Waiver of Subrogation Needed [dropdown: No / Yes - blanket / Yes - specific parties / Unsure].

Form type: Update / setup (up), auth-only. Niche: Insurance. Deployment: standalone.

Best for / surface when: Insurance client workflow — coverage targets & current policy.