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Leadership Insurance Agency

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Type of Insurance
State
We can only insure residents of (or vehicles registered in) Indiana, Illinois, Michigan and Wisconsin.

Health Links coming soon!

Specialty Insurance
We can help you with any of the following insurance needs below. Please let us know just a little bit about your specific needs, and we will contact you for additional information.
Insurance Quote
- Motorcycle
- ATV
- RV
- Flood
- Umbrella
- Other- see notes below
Comments

Contact Information
Name*
Email*
Phone
Best time to reach you
Comments

Auto Discounts!
Discounts
- Doctor
- RN
- Dentist
- Teacher
- Police
- Firefighter
- Affinity (select occupations)
- Multi Car Discount
- Auto/Home
- Auto/Renters
- Auto/Life
- Alternative Fuel
- Good Student
- Safe Driving Discount
Enter all the discounts that you think you may eligible for. And we will talk to you to see if more apply... we offer more discounts than any other company we know!

Your Address
Street Address
City
Zip
Are you currently insured?
- Yes
- No
Current Auto Insurance Company
Do you wish to upload a copy of your current policy?
- Yes
- No
Upload Current Policy
This is optional. If you have a pdf or digital copy of your current policy it may help us provide a more accuarte quote.
Details:
How long has it been since you last had coverage?

Coverage Options
Towing Coverage
Rental Coverage
Full Glass
Liability Limits
Notes

Vehicle 1
Year - Make - Model
Comprehensive Deductible
Notes
Full Glass?
Collision Deductible
Notes
More vehicles to quote?
- Yes. I have another vehicle.
- Nope. I only have 1 vehicle.
Please click the Next button below to continue the quote. Thanks!
Vehicle 2
Year - Make - Model
Comprehensive Deductible
Notes
Full Glass?
Collision Deductible
Notes
More vehicles to quote?
- Yes. I have a third vehicle.
- Nope. All done. Just 2 vehicles.
Please click the Next button below to continue the quote. Thanks!
Vehicle 3
Year - Make - Model
Comprehensive Deductible
Notes
Full Glass?
Collision Deductible
Notes
More vehicles to quote?
- Yes. I have more.
- Nope. I have only 3 vehicles.
Please click the Next button below to continue the quote. Thanks!
Additional vehicles to insure:
Enter information on more than 3 vehicles.

Driver #1
Driver Name
Date of Birth
Gender
- Female
- Male
Marital Status
- Single
- Married
Driving Record
- EXCELLENT
- GOOD
- FAIR
- POOR
Additional information about driving records
Add another driver?
- Yes
- No
Please click the Next button below.
Driver #2
Driver Name
Date of Birth
Gender
- Female
- Male
Marital Status
- Single
- Married
Driving Record
- EXCELLENT
- GOOD
- FAIR
- POOR
Add another driver?
- Yes
- No
Please click the Next button below.
Driver #3
Driver Name
Date of Birth
Gender
- Female
- Male
Marital Status
- Single
- Married
Driving Record
- EXCELLENT
- GOOD
- FAIR
- POOR
Add another driver?
- Yes
- No
Please click the Next button below.
Additional drivers information

Address
Street Address
City
Zip Code
Is the property located at the address above?
- Yes
- No
Location of the property
Are you currently insured?
- Yes
- No
Details
How long has it been since you last had coverage?

About You
Date of Birth
Gender
- Female
- Male
Marital Status
- Single
- Married
Claims in last 3 years
Type of policy you need

Property Information
Year Home Built
Square Feet
Home Style
Describe Home Style
Garage
Garage Description
FULL Baths
1/2 or 3/4 Baths
Roof Type
Describe Type of Roof
Exterior Wall
Describe Exterior Wall
Other Structures
- Fireplace
- Deck
- Patio
- Pool
- Other
Describe other structures

Contents Coverage
Contents Coverage Amount
Special Coverage Needed
- Furs
- Jewelry
- Fine Arts
- Cameras
- Collectibles
- Gold/Silver/Coins
- Other- describe below
Contents Information

Homeowners Discounts
Deadbolts on all doors
- Yes
- No
Smoke Alarms
- Yes
- No
Fire Extinguisher
- Yes
- No
Monitored Security System
- Yes
- No
Additional Comments

Just a few questions
Age
Height
Weight
Tobacco Use
General Health
Amount of coverage
Type of policy
Display Comments Field Below
- Yes
- No
Comments

Business Information
Business Name
Business Street Address
Business Zip
Business Coverages
- Property
- Liability
- Commercial Auto
- Work Comp
Comments

All Done!
Please click the Submit button below, or the Previous button to go back and edit your information. Thanks so much for the opportunity to help you!
Phone
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We're here...
ready to help!

Our team:

Benny Bendit bio email Ben
Joyce Bendit bio email Joyce
Carla Giles bio email Carla
David Giles bio email David
Byron Zachary bio email Byron

Leadership Insurance Agency

Bus: (574) 277-1611

Fax: (574) 273-4557

52303 Emmons Road, Suite 31

South Bend, Indiana 46637

Map to our office

Links

Insurance 101
Kelley Blue Book
NADA Guides
CarFax.com

Contact Us

Leadership Insurance Agency

Bus: (574) 277-1611

Fax: (574) 273-4557

52303 Emmons Road, Suite 31

South Bend, Indiana 46637

Map to our office

Helpful Links

Insurance 101
Kelley Blue Book
NADA Guides
CarFax.com

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NOTICE OF LICENSURE

The Leadership Insurance Agency is licensed to conduct business in Indiana, Illinois, Michigan and Wisconsin. The information on this site is a solicitation to conduct business only in the aforementioned state of authority.

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