Renters Insurance Quote Request

Applicant Information

What information will you need?

You will need information on your rental unit construction and heating, specific coverages and deductibles desired and possessions replacement costs.¹

Live in MA? Please apply here.
Or if you live outside of MA, NH, CT, ME, CO or GA, please contact us directly at 508.263.6978.

First, Tell Us About Yourself . . .

First name:

Last name:

Are you a DCU member?

yes no

Date of birth:

Occupation:

Employer:

Number of years at employer:

Is there a second insured?

yes no

First name (2nd Insured):

Last name (2nd Insured):

Is the second insured a DCU member?

yes no

Date of birth (2nd Insured):

Occupation (2nd Insured):

Employer (2nd Insured):

Number of years at employer (2nd Insured):

Address of property to be insured:

City:

State:

Zip:

County:

Fire dept.:

Mailing address (if different):

Daytime phone:

Email address:

¹ Insurance companies use information gathered from you and often from outside sources about your insurance claim history, property and credit history. This allows them to determine the proper insurance premium pricing and provide a more accurate quote. Accessing your credit information for this purpose has no impact on your credit rating. By submitting this form, you are authorizing DCU Insurance and/or our insurance carriers to access your insurance reports.

* Required fields.

Renters Insurance Quote Request

For members living in NH, CT, ME, CO and GA

Applicant Information

First, Tell Us About Yourself . . .

Rental Unit Information

Next, tell us about the unit you're renting . . .

Possessions Information

Next, tell us about your possessions . . .

Coverages Information

Just a few more general questions . . .

And some final insurance coverage questions . . .