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Personal Lines Application

1 of 4

What would you like to quote?

Homeowners(Required)
Collections(Required)

Collections

Fill any applicable columns.

Itemized
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
No. of Items
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
Blanket
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
Umbrella(Required)

Umbrella

Fill any applicable fields.

EPLI
Not For Profit D&O
Auto(Required)

Auto

Driver(Required)
Driver Name
Date of Birth
License Number
State
Usage
 

Vehicles

Fill one row for each vehicle.

Vehicle(Required)
Year
Make/Model
Value of Vehicle
VN#
State
Assigned To
 

Drivers

Fill one row for each driver.

Show MVR/CLUE?

MVR/CLUE:

MVR/CLUE
Type
Date
Driver
Details
 

General Information

Homeowners

Has the current policy been cancelled, non-renewed or is location for sale?
Is this a new purchase?
Is this the same location as listed above?(Required)

Rentals

LLC/Trust

Is home owned in an LLC or trust?

Personal Lines Application

2 of 4

Pool/Hot Tub(Required)
Losses within last 5 years

Losses

Losses(Required)
Date of Loss
Type of Loss
Details
Amount Paid
Open? (Yes/No)
 

Coverage Amounts

Homeowner Credits (check all that apply)

Homeowner Credits

Fire Protection

Fire Protection

Personal Lines Application

3 of 4

Wind Mitigation Credits(Required)
Reinforced Concrete Roof Deck(Required)
SWR(Required)

Personal Lines Application

4 of 4

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Accepted file types: doc, docx, pdf, Max. file size: 50 MB.

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    Small Commercial
    Insurance

    Florist Insurance

    Target Markets (under $20k premium)

    View Carrier Listing

    Class of Business (Not all Inclusive)

    Artisan/Trade Contractors (NO GC's)
    Auto Repair/Garages
    Bakeries
    Beauty Salons/Barber Shops
    Builder's Risk - Commercial & Residential
    Delicatessens
    Distributors/Wholesalers
    Doctors/Physicians Offices
    Electrical Contractors
    Florists
    Landscape/Lawn Maintenance
    Law Firms (excluding Professional)
    Lessors Risk — Building Owners
    Manufacturers
    Offices
    Restaurants
    Retail / Stores / Chains
    Religious Institutions
    Shopping Centers
    Technology

    Lines of Business

    Auto
    Bonds
    BOP
    Builder's Risk
    Equipment Breakdown (Monoline or Package)
    Excess GL/Auto/Property/Flood
    Flood
    General Liability (Monoline or Package)
    Inland Marine (Monoline or Package)
    Liquor Liability (Monoline or Package)
    Professional Liability incl. Mgmt. Liability/Cyber/D&O/E&O/Fiduciary/Crime
    Umbrella (Monoline or Package)
    Workers' Compensation

    Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].

    Middle Market
    Insurance

    Target Markets (under $20k premium)

    View Carrier Listing

    Class of Business (Not all Inclusive)

    Artisan/Trade Contractors
    Banks / Financial Institutions
    Builder’s Risk — Lessors Risk — Building Owners
    Country Clubs / Golf Courses
    Distributors / Wholesalers
    Electrical Contractors
    Food Distributors
    General Contractors
    Heating & A/C Contractors
    Hospitals

    Landscape/Lawn Maintenance
    Law Firms (excluding Professional)
    Lessors Risk — Building Owners
    Manufacturers
    Offices
    Restaurants
    Retail / Stores / Chains
    Religious Institutions
    Shopping Centers
    Technology

    Lines of Business

    Auto (Monoline or as Fleet)
    Bonds
    Builders Risk
    Earthquake / DIC
    Equipment Breakdown (Monoline or Package)
    Excess GL / Auto / Property / Flood
    Flood
    General Liability (Monoline or Package)
    Inland Marine (Monoline or Package)
    Liquor Liability (Monoline or Package)
    Products Liability
    Professional Liability including Management Liability / Cyber / D&O / E&O / Fiduciary / Crime
    Property (Monoline or Package)
    Railroad Protective Liability
    Umbrella (Monoline or Package)
    Workers Compensation (Monoline or Package)

    Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].

     

    Success Lists

    The Halcyon Success Lists is a small sampling of our monthly new business production in each department. Please contact us if you have any questions at [email protected]

    • Middle Markets
    • Small Business
    • Personal Lines

    Middle Markets

     

    2026
    Year to Date
    2025
    Year to Date
    2024
    Year to Date
    2023
    Year to Date
    2022
    Year to Date
    2021
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    2020
    Year to Date
    2019
    Year to Date
    2018
    Year to Date

    Small Business

    2024
    Year to Date
    2023
    Year to Date
    2022
    Year to Date
    2021
    Year to Date
    2020
    Year to Date

    Personal Lines

    2024
    Year to Date

    Supplemental
    Forms

     Broker of Record – Letter of Assignment
     Named Insured Chart
     LRO Supplemental Application
     No Known Loss Certification
     Builder’s Risk Application

    International Partners

    Auto Trends

    • Travelers – 2022 Auto Trends
    • Chubb – 2022 Auto Trends

    Training On Demand

    Halcyon Workshop: How to Quote Cyber?

    Payment Address

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    Atlanta, GA 31193-1817

     

    Overnight Payment Address

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    Lockbox # 931817
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    Upcoming Events

    There are no current upcoming events, please check back soon.

    Insurance Journal

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    Wed, 1 April 2026 10:19 am
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    Wed, 1 April 2026 09:59 am
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    Read More
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    Wed, 1 April 2026 09:08 am
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    Read More
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    NAIC Issues Nationwide Data Call to Homeowners Insurers
    Wed, 1 April 2026 05:24 am
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    Read More
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    Wed, 1 April 2026 05:14 am
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    Wed, 1 April 2026 05:01 am
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    Read More
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    Wed, 1 April 2026 05:01 am
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    Read More
    Viewpoint: California’s Surplus Lines HO Market Driven by Access, Not Wildfire Risk
    Wed, 1 April 2026 05:00 am
    It’s been more than two years since I wrote an analysis based on Surplus Line Association of California insight and data for an Insurance Journal article forecasting that the state’s homeowners insurance market was entering a structural transition driven primarily …
    Read More
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    Wed, 1 April 2026 05:00 am
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    Wed, 1 April 2026 05:00 am
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    Tue, 31 March 2026 04:00 pm
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    Tue, 31 March 2026 03:36 pm
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    Tue, 31 March 2026 02:36 pm
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    Tue, 31 March 2026 01:36 pm
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    Tue, 31 March 2026 01:14 pm
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    FAQS

    HOW DO I UPDATE MY EFT AND DIRECT DEPOSIT INFORMATION?

    1. First, download and complete the ACH form and enter your New account And routing numbers. This form is also available once logged in to halcyonuw.com in the ePay section.
    2. Scan a copy of a voided check to include with your completed forms.
    3. Email your completed ACH form with the scan of your voided check to Halcyon’s accounting operations team at [email protected].

    HOW CAN I OBTAIN A PRODUCER CODE FOR MY NEW LOCATION?

    Send an email to [email protected] with the following information:

    • Main Office Producer Code
    • Physical & Mailing Address
    • Phone number
    • Fax number
    • First and last name of main contact person
    • Main contact email address

    If the new location will use the same account information for ACH (Direct Deposit) as your main office, you can state that in the email. If the new office will be using their own ACH (Direct Deposit) information, please be sure to include new ACH form for that office.

    HOW CAN I UPDATE MY AGENCY CONTACT INFORMATION?

    Send an email to [email protected] and give us all your new contact information. Please let us know if any contacts specialize in certain lines of business – (Example: John Smith – [email protected] – Personal Lines).

    HOW CAN I OBTAIN A USER ID AND PASSWORD?

    For Hiscox, Halcyon Workshop, and Neptune, you can create your own ID and password. For all other systems, please contact [email protected].

    WHEN ARE COMMISSIONS PAID?

    • Commissions are deposited on the 10th business day of each month.
    • If you have any accounting questions, please email us at [email protected] or [email protected].

    Claims

    Reporting


    If you have any problems or concerns please contact Halcyon Underwriters.

    Report A Claim

    AIG: To inquire about a U.S. claim: (877) 802-5246
    Report A Claim
    AIG Private Client Group - Personal Lines
    Report A Claim

    Fireman’s Fund Insurance Company is now integrated into Allianz Global Corporate & Specialty (AGCS). This consolidation means that current Fireman’s Fund policyholders and their brokers will benefit from the same focused insurance offerings, but with the added bonus of Allianz’s global reach and infrastructure.
    Update: Eff 4/1/17 - Fireman's Fund Personal Lines Inquiries number to call is (800) 945-7461. Email Inquiries effective 4/1/17 will be [email protected] for any former fireman's fund policy.
    Allianz Key Contact Information
    To report a New Claim: [email protected]
    Or call: 1-888-347-3428
    All other claims services: 1-800-870-8857
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    Business Auto Claim: Call 1-800-897-4865

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    For claims information or to file a claim contact Braishfield
    Phone: (888) 335-6615
    Email: [email protected]
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    Email Reporting: [email protected]
    First Notices Phone: (803) 735-0672
    First Notices Fax: (855) 285-1165
    Report A Claim

    Coterie

    Report A Claim
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    Email: [email protected]
    Peninsula Insurance Bureau
    2842 Lent Road
    Apopka, Florida 32712

    Phone: (407) 880-1100
    Fax: (407) 880-1102
    Email: [email protected]
    Dual Flood & Home
    Report A Claim
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    Fireman's Fund is now part of Allianz Global.

    Please select "Allianz Global Corporate & Specialty" to file a claim.

    FFVA Mutual Logo
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    Claims Hotline: (888) 639-2567
    Fax: (570) 825-0611
    Email: [email protected]
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    Phone: (800) 466-9165
    Fax: (201) 729-1010
    Email: [email protected]
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    For your claim reporting needs, you can report your claim by phone by calling (800) 362-0000. You can also email the loss notice to: [email protected] or fax it to (800) 329-3297
    Once the claim is reported, please send any correspondence related to this claim, with reference to the claim number by mail, email or fax to be added to our claim file:

    Mail: PO Box 515097 Los Angeles, CA 90051
    Email: [email protected]
    Fax: (888) 268-8840
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    For your claim reporting needs, please contact Kathy Souhlaris at [email protected]
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    Phone: (914) 381-4286
    Email: [email protected]
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    Safeco Claims Contact Center - Call Directly at (800) 332-3226 to report a claim 24 hours/7 days a week.
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    Fax: (770) 836-8563
    Email: [email protected]
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    Claims

    Phone: 1.855.782.7725
    Email: [email protected]
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    Phone: (888) 480-1853
    Fax: (888) 551-2982
    Email: [email protected]
    Real Estate Professional
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    Cyber
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    Architects & Engineers
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    Newsletters

    • Previous Years
    2021
    First Quarter
    Second Quarter
    Third Quarter
    Fourth Quarter
    2020
    First Quarter
    Second Quarter
    Third Quarter
    Fourth Quarter

    Personal Lines

    Guidlines/Forms

    Surplus Lines Diligent Effort Form
    Supplemental Named Insured Questionnaire

    Guidelines

    AIG Guidelines Current

    Marketing - Auto

    AIG Auto Experience a Difference
    Auto Brochure
    Auto Coverage Summary
    Auto Packet
    Cash Settlement Brochure

    Marketing - Equipment Breakdown

    AIG Equipment Breakdown Coverage Summary

    Marketing - Excess

    AIG Excess
    AIG Personal Excess Coverage Summary

    Marketing - Home

    AIG Home Credits List
    AIG Homeowners Coverage Summary
    AIG Homeowners
    AIG PCGHomeowners
    Fraud Brochure
    Fraud
    Household Safeguard Brochure

    Marketing - Misc.

    AIG PCGPrivate Collections Brochure
    Claims Service

    Questionnaires

    Equine Questionnaire
    FL PIP Form
    PCHO – SHC FL (11-10) Sinkhole Coverage Extension Florida
    PCHO – WHC (8-00) Wind or Hail Exclusion
    PEL FL UM Select-Reject Form
    Request to Exclude Contents Coverage
    Request to Exclude Windstorm and Hail Coverage
    UM Form
    Work Comp App

    Misc.

    Understanding Our Yacht Wind Strategy

    Guidelines

    Chubb - Florida Wind Strategy
    Flood Eligibility Guidelines
    Lead With Chubb
    Why Chubb
    Chubb – Market Trends 2022: Key Facts
    Chubb – Market Trends 2022: Action Sheet

    Marketing - Auto

    Chubb – Auto Trends
    Chubb – Auto Comparison
    Chubb – Auto Testimonial
    Chubb - Auto Top 10
    Chubb - Auto
    Chubb – Young Drivers
    Chubb – Auto Testimonial 2
    Chubb – Collector Car Testimonial
    Chubb Mobile App

    Marketing - Cyber

    Chubb Cyber Solutions

    Marketing - Employment Practices

    EPLI FAQ’s
    EPLI

    Marketing - Equipment Breakdown

    Chubb – Equipment Breakdown Brochure

    Marketing - Excess Liability

    Chubb – Excess Marketing
    Chubb – Excess Sell Sheet

    Marketing - Flood

    Chubb – Benefits of Chubb Flood vs NFIP Brochures
    Chubb Excess Flood FAQ
    FL Chubb Excess Flood Application 16
    FL Chubb Primary Flood Application 16

    Marketing - Homeowners

    Chubb – Comparison
    2022 Construction Costs
    Chubb – HO Testimonial
    Chubb – HO Testimonial 2
    Chubb – HO Testimonial 3
    Chubb – HO Top Ten
    Homeowners - Marketing
    Homeowners - Heat Sensors FAQ

    Marketing - Passport 360

    Chubb – Passport 360 E Brochure
    Chubb – Passport 360 Agent FAQ
    Passport Options

    Marketing - Valuable Articles

    Chubb – VAC

    Marketing - Yacht/Watercraft

    Chubb – Boaters: Coming Out of Lay-Up Guide

    Misc.

    Account Bill – FAQ
    ADT Custom Home Services
    Family Protection
    Chubb – HO Credits
    Fire Claims - Case Studies

    Supplementals

    California Location Check Request Template
    Chubb Flood Excess App
    Chubb Flood Primary App
    Chubb UM Form
    Chubb UM Form – Excess
    Chubb VA Profile
    EPLI Questionnaire
    No Loss Letter
    Passport Enrollment Form

    Caribbean Homeowners

    Caribbean Homeowners Application Form

    Flood

    DUAL Private Primary Flood Program
    DUAL Excess Flood Application
    Flood Policy

    Yacht

    Dual High Value Yacht App
    Dual Recreational Vessel App
    Yachts Marketing Sheet

    Forms

    Blank PIP Form
    Blank UM Form

    Misc.

    Homeowners Quick Reference Guide

    Forms

    Safeco Watercraft Quick Quote Form
    UM Form w NS Form
    XS UM Rejection Form
    Safeco Classic Car Quote Form
    Safeco Motorcycle Quote Form
    Safeco RV Quote Form
    Safeco Watercraft Quote Application

    Guidelines

    Auto Guidelines
    Motorcycle Guidelines
    Umbrella Guidelines
    Watercraft Guidelines

    PMT Forms

    EFT Form
    Safeco CC Form

    Misc.

    Loss of Use Coverage
    Mobile App with Claim Capabilities
    New Express Estimating
    Right Track FAQ’s
    Roadside Assistance
    Safeco Coverage Levels
    New Digital Enhancements Drive Results
    Safeco Specialty Products
    Safeco Specialty Essentials
    A Tale of Two Classic Cars

    Forms

    TIC EFT Enrollment
    TIC RCC Form
    Travelers UM Form
    XS UM Form

    Marketing - Auto

    2022 Auto Trends

    Marketing - Home

    2022 Home Trends

    Guidelines

    Auto Guidelines
    Umbrella Guidelines

    Misc.

    Access your Travelers account with MyTravelers®
    Discounts Quantum 2.0
    Roadside vs Premier Roadside Assistance

    Staff Directory

    Adele Brennan
      Personal Lines Director
      Personal Lines
      [email protected]
      (978) 548-3763
    Allison Shaievitz
      Operations Representative
      Personal Lines
      [email protected]
      (305) 728-7796
    Andrea Boswell
      Operations Assistant / Receptionist
      Marketing & Operations
      [email protected]
      (321) 587-4271
    Augusta Godinho - Team Leader
      Sr. Production Underwriter/VP
      Middle Market (Augusta's Team)
      [email protected]
      (407) 660-5905
    Brian Polino - Team Leader
      Managing Director/EVP
      Middle Market (Brian's Team)
      [email protected]
      (321) 527-2198
    Brittany Pearson
      Accounting & Finance Associate
      Accounting
      [email protected]
      (321) 527-2189
    Chelsea Thoms - Team Leader
      Production Underwriter
      Middle Market (Chelsea's Team)
      [email protected]
      (321) 587-4264
    Cindy Kelly
      Operations Supervisor
      Personal Lines
      [email protected]
      (978) 548-3757
    Cindy Smith - Division Leader
      Operations Leader
      Marketing & Operations
      [email protected]
      (321) 527-2180
    Cinnamon Sanjurjo
      Assistant Underwriter
      Personal Lines
      [email protected]
      (321) 587-4276
    Deidre Barnecott
      Assistant Underwriter (E-K)
      Middle Market (Brian's Team)
      [email protected]
      (321) 587-4275
    Deirdre Sanford - Division Leader
      Small Business Leader / VP
      Small Business
      [email protected]
      (407) 660-5901
    Devin Osborne - Team Leader
      Production Underwriter
      Middle Market (Devin's Team)
      [email protected]
      (321) 527-2196
    Elizabeth Woods
      Assistant Underwriter (R-Z)
      Small Business
      [email protected]
      (407) 660-5917
    Erin McKenna
      Account Manager
      Personal Lines
      [email protected]
      (978) 548-3768
    Eva Cruzada
      Sr. Assistant Underwriter
      Middle Market (Paul's Team)
      [email protected]
      (407) 660-5908
    Felisa Deutscher
      Assistant Account Manager
      Personal Lines
      [email protected]
      (978) 743-7301
    Francis Willmore
      Assistant Underwriter (L-Q)
      Middle Market (Brian's Team)
      [email protected]
      (321) 527-2182
    Greg Costas
      Operations Representative
      Personal Lines
      [email protected]
      (772) 257-7994
    Gunter Munoz
      Assistant Underwriter (Renewals F-O)
      Middle Market (Augusta's Team)
      [email protected]
      (321) 587-4281
    Heleina Correa
      Sr. Assistant Underwriter
      Middle Market (Devin's Team)
      [email protected]
      (321) 527-2185
    Jennifer Eick
      Asst. Production Underwriter
      Small Business
      [email protected]
      (321) 527-2193
    Jenny Piccard
      Assistant Underwriter
      Personal Lines
      [email protected]
      (407) 215-4796
    Jill Biega - Division Leader
      Accounting & Finance Leader
      Accounting
      [email protected]
      (407) 660-5904
    Juliana Losardo
      Sr. Assistant Underwriter (Renewals P-Z)
      Middle Market (Augusta's Team)
      [email protected]
      (407) 660-5914
    Katey Andrews
      Assistant Underwriter (D-J)
      Small Business
      [email protected]
      (321) 587-4279
    Kara Carrier
      Account Manager
      Personal Lines
      [email protected]
      (772) 226-5546
    Kyle Cogburn
      Assistant Underwriter (#'s, A-D)
      Middle Market (Brian's Team)
      [email protected]
      (321) 527-2183
    Larissa Shakespeare
      Asst. Production Underwriter
      Middle Market (Brian's Team)
      [email protected]
      (407) 660-5913
    Laura Ducharme
      Sr. Personal Lines Underwriter
      Personal Lines
      [email protected]
      (321) 527-2195
    Lauren Kovacsik
      Personal Lines Underwriter
      Personal Lines
      [email protected]
      (407) 660-5919
    Lisa Catineau
      Personal Lines Underwriter
      Personal Lines
      [email protected]
      (321) 527-2188
    Luciano Sanfilippo
      Assistant Underwiter (Trainee)
      Middle Market (Brian's Team)
      [email protected]
      (321) 587-4282
    Maday Senespleda
      Sr. Assistant Underwriter (K-Q)
      Small Business
      [email protected]
      (407) 660-9468
    Marisa Jackson
      Sr. Account Manager
      Personal Lines
      [email protected]
      (978) 548-3793
    Michael Carolan
      Business Development Leader
      Marketing & Operations
      [email protected]
      (321) 257-0250
    Noelle Srour
      Assistant Underwriter
      Personal Lines
      [email protected]
      (407) 660-5918
    Paige Shaw
      Sr. Assistant Underwriter (#'s, A-C)
      Small Business
      [email protected]
      (321) 587-4269
    Samadur Rahman
      Financial Operations Review Analyst
      Accounting
      [email protected]
      (407) 215-4790
    Samantha Cardillo
      Assistant Underwriter (#'s, A-L)
      Middle Market (Chelsea's Team)
      [email protected]
      (321) 587-4259
    Sandra Schmidt
      Assistant Underwiter (Trainee)
      Middle Market (Chelsea's Team)
      [email protected]
      (321) 587-4285
    Sarah Cadle - Division Leader
      Personal Lines Leader/VP
      Personal Lines
      [email protected]
      (321)-527-2192
    Stacey Arrendondo
      Account Manager
      Personal Lines
      [email protected]
      (772) 226-5647
    Staci Paro
      Operations Representative
      Personal Lines
      [email protected]
      (978) -548-3747
    Susie Lopez
      Sr. Assistant Underwriter
      Middle Market (Paul's Team)
      [email protected]
      (407) 660-5912
    Susie Lopez
      Sr. Assistant Underwriter (Servicing #'s, A-J)
      Middle Market (Augusta's Team)
      [email protected]
      (407) 660-5912
    Vanessa Diehl
      Assistant Underwriter (R-Z)
      Middle Market (Brian's Team)
      [email protected]
      (407) 660-5900
    Wendy McCoy
      Assistant Underwiter (Servicing K-Z)
      Middle Market (Augusta's Team)
      [email protected]
      (321) 587-4278
    Yedila Pereda
      Sr. Assistant Underwriter (Renewals #'s-E)
      Middle Market (Augusta's Team)
      [email protected]
      (321) 527-2191

    Small Commercial
    Insurance

    Florist Insurance

    Target Markets (under $20k premium)

    View Carrier Listing

    Class of Business (Not all Inclusive)

    Artisan/Trade Contractors (NO GC's)
    Auto Repair/Garages
    Bakeries
    Beauty Salons/Barber Shops
    Builder's Risk - Commercial & Residential
    Delicatessens
    Distributors/Wholesalers
    Doctors/Physicians Offices
    Electrical Contractors
    Florists
    Landscape/Lawn Maintenance
    Law Firms (excluding Professional)
    Lessors Risk — Building Owners
    Manufacturers
    Offices
    Restaurants
    Retail / Stores / Chains
    Religious Institutions
    Shopping Centers
    Technology

    Lines of Business

    Auto
    Bonds
    BOP
    Builder's Risk
    Equipment Breakdown (Monoline or Package)
    Excess GL/Auto/Property/Flood
    Flood
    General Liability (Monoline or Package)
    Inland Marine (Monoline or Package)
    Liquor Liability (Monoline or Package)
    Professional Liability incl. Mgmt. Liability/Cyber/D&O/E&O/Fiduciary/Crime
    Umbrella (Monoline or Package)
    Workers' Compensation

    Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].