Policy Change Requests

Policy Change Requests
For service on your insurance policy you can contact one of our customer service representatives at (504) 455-7283 or complete our Personal & Commercial Auto Change Request Form.

On this form (Policy Change Requests), you can request to add or remove a personal  or commercial vehicle, add or remove a driver, or notify us of an address change.

Fill Out This Short Form For A Quick Call Back….

    DISCLAIMER:
    I understand that NO CHANGE to my policy or coverage are binding by submitting this online policy change request. This change request will only be considered bound upon confirmation from my Broker/Agent.

    Please check all boxes that apply:

    Change Of AddressAdd or Delete A DriverAdd or Delete A VehicleAdd or Delete CoveragesAdd or Delete a LienholderAdd or Delete A MortgageeRequest An ID CardRequest A Declaration PageRequest A Certificate Of InsuranceOther:

    Someone will contact you within 1 hour of this request (Monday - Friday 9am to 5pm or Saturday 9am - 1pm) to verify all information and/or bind any coverages needed. If you would rather speak to someone regarding these changes please give us a call at at 504-455-7283.

    No changes or coverages will be considered binding on this request form until confirmation is received from my Broker/Agent Dan Burghardt Insurance.

    Insurance Quote

    Get an IMMEDIATE call back from a licensed insurance agent...usually within a few minutes! (during normal business hours Monday - Friday 9am - 5:30pm - After hours, please call our 24 hour help desk at 504-441-7283)

      Contact details:

      Your information is never transferred to any third party. By submitting this form, you will get a call back from OUR OFFICE to finalize your insurance request.