You are requesting a Motorcycle insurance quote for the State of Michigan. This streamlined form is designed to take a minimal amount of time to fill out and still provide you with an accurate quote.
First Name
*
Last Name
*
Date of Birth
*
Experience
*
select
0 - 12 months
1 year
2 years
3 years
5 years
10 years+
Spouse (if Licensed Rider)
Date of Birth
Experience
select
0 - 12 months
1 year
2 years
3 years
5 years
10 years+
Contact Phone
*
Email Address
*
Current Address
*
City
*
State
MI
Zip
*
Home
*
Own
Rent
Other
Prior Address (if less than 2 years at your current address)
Prior
City
State
- - Choose One - -
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
Liability Limits
*
20/40
50/100
100/300
250/500
other
not sure
Medical Coverage
*
none
1,000
5,000
10,000
20,000
other
not sure
Bike 1
Year
*
Make
*
select
Aprilia
Benelli
BMW
Ducati
Harley-Davidson
Honda
Kawasaki
Piaggio
Suzuki
Triumph
Victory
Yamaha
Other (include w/model)
Model, CC's
*
Optional Equipment
*
select
None
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
$10,000
$15,000
Other
Not sure
Collision
*
select
No Coverage
$250
$500
$1,000
Other
Not Sure
Comprehensive
*
select
No Coverage
$0
$50
$100
$250
$500
Other
Not Sure
Bike 2, for any additional bikes, use the comments section below
Year
Make
select
Aprilia
Benelli
BMW
Ducati
Harley-Davidson
Honda
Kawasaki
Piaggio
Suzuki
Triumph
Victory
Yamaha
Other (include w/model)
Model, CC's
Optional Equipment
select
None
$1,000
$2,000
$3,000
$4,000
$5,000
$6,000
$7,000
$8,000
$9,000
$10,000
$15,000
Other
Not sure
Collision
select
No Coverage
$250
$500
$1,000
Other
Not Sure
Comprehensive
select
No Coverage
$0
$50
$100
$250
$500
Other
Not Sure
Any Moving Violations in the last 3 to 5 years? If yes, please briefly state, when and what for...
Current Insurance Company
Current policy expiration date
Comments and/or additional information
