The following form is provided to you for making changes or requests on your existing policies. By submitting this form you understand that no coverage or premium adjustment of any kind is bound until you receive written notice from us.
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Insurance products are offered through the following insurers: Amerisafe (DeRidder, LA); Arch Insurance (New York, NY); Crum and Forster (Morristown, NJ); EMC Insurance Companies (Des Moines, IA); Energi (Peabody, MA); Erie Insurance (Erie, PA); ICW Group Insurance Srvs (San Diego, CA); National Interstate (Richfield, OH); Nationwide Insurance (Columbus, OH); The Progressive Corporation (Mayfield Village, OH); Rockwood Casualty Insurance Company (Rockwood, PA); Utica National Insurance Group (New Hartford, NY); UPMC (Pittsburgh, PA); Aetna Medicare Solutions (Lexington, KY); Highmark Health Insurance (Pittsburgh, PA); UnitedHealthcare (Hartford, CT); and other unaffiliated insurers.
Insurance services are provided by an independent insurance agency. Marshall Insurance Brokers and its producers are licensed in the states where services are offered. License numbers are available upon request. Availability, eligibility, and coverages may vary by state. Not all products are available in all states.
