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Home means comfort, and comfort means coverage.
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Protect your family's future.
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Home protection plans
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Condo insurance
Never worry about your personal property.
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For those who're always prepared.
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Coverage for every adventure.
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Home
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About Elephant
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Agency Partnerships
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Agency Partnership Form
Contact us for more information about the Elephant Agency Program
Contact & Agency Information
Name of person completing this form
(Required)
(First & Last)
Agency name
(Required)
Title / Role
Principal / Owner
Agency Manager
Producer / Agent
Other
Email address
(Required)
Phone number
(Required)
Agency website
How did you hear about Elephant?
Agency Profile
How many agents/producers work within your agency?
(Required)
State(s) you do business in
Georgia
Illinois
Indiana
Maryland
Ohio
Tennessee
Texas
Virginia
Other
Approximately what is your agency's annual personal auto insurance premium?
> $1 Million
+ $1 Million
+ $3 Million
+ $5 Million
+ $10 Million
What products or services does your agency currently offer?
Personal P&C
Commercial P&C
Life Insurance
Health Insurance
Employee Benefits
Financial Services / Wealth Management
Others
Select all that apply
What other products or services does your agency offer?
Carrier Information
Please provide information for your top three personal auto carriers
Carrier Name
Approx. Annual Premium
Current Loss Ratio
$
%
Add
Remove
$
%
Add
Remove
$
%
Add
Remove
Technology & Setup
EZLynx
PL Rating
TurboRater / ITC
Other
We do not currently use a comparative rater, quote all carriers direct
What is your software called?
How would you prefer to receive Elephant policy downloads/transaction reporting?
IVANS
SFTP
Not Sure
Would your agency like access to an Elephant SWEEPS account?
Yes
No
Not Sure
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.