www.InsureMeWC.com
Ca.Lic. #0E50745
USA - (818) 788-5353
Mex - 01 (800) 099 0614
WHATS APP? : YES NO
Click this box if your Whats App # is the same as your mobile # above*
IS THE LEGAL OWNER OF THIS MEXICO PROPERTY THE SAME AS OWNER DETAILS? : (This is the Legal Name Listed on your Fideicomiso (If Applicable)
IS THE LEGAL OWNER OF THIS MEXICO PROPERTY OWNED BY A CORPORATION/LLC? : (This is the Legal Name Listed on your Fideicomiso (If Applicable)
CLICK HERE if the Address Details Above for the "OWNER" is the Same for the Corporation/LLC. (AUTO FILL).
Is this Insurance Request for a Home/Condo you Own Now or a Future Purchase?* SELECT New Purchase Refinance Other
HOW MANY ADDITIONAL INSURED'S WOULD YOU LIKE TO ADD? :
The Dwelling Replacement Cost does not include land value. The insured sum is calculated by taking the cost per square foot to rebuild and multiplying by the air conditioned square footage of your home or condo.
WHAT FLOOR IS YOUR UNIT IS ON?
HOW MANY FLOORS ARE IN YOUR BUILDING?
HOW MANY UNITS ARE IN YOUR BUILDING?
HOW MANY BUILDINGS ARE IN YOUR DEVELOPMENT?
BUILDING INSURED BY
If Yes, Please provide description of the underground area? This can include a wine cellar, storage or supply room, guest bedroom, etc. (Mexico insurance carriers exclude coverage for rooms or basements that are underground. Under special endorsement, some, not all carriers in Mexico will provide some coverage under special endorsement. Insurance carrier acceptance required, when applicable.) :
ROOF?:
PLUMBING/HEATING?:
ELECTRICAL?:
SELECT HOW MANY CLAIMS YOU HAVE FILED?
DWELLING/BUILDING – Replacement Cost Value*
DWELLING/BUILDING – This figure is calculated by multiplying the square footage of the air conditioned space of your Home or Condo by the cost per square foot to build/rebuild. Cost per sq.ft. is not to be lower than $100.00 per sq. ft & depending on finishing touches in your home or condo could be as high as $600.00. (DO NOT INCLUDE LAND VALUE)
Excluding Dwelling/Building Coverage Offers No Structural or Betterments & Fixtures Protection**
OTHER STRUCTURES – Replacement Cost Value*
OTHER STRUCTURES Coverage is up to the limit of liability indicated on the Declaration Page for this Coverage, any other structures on the residence premises that is not considered as a Dwelling Structure. This includes: 1. Structures set apart from the dwelling by a clear space; and 2. Structures connected to the dwelling by only a fence, utility line, or similar connection; and 3. Fences, patios, walkways, pools or walking areas in the open; and 4. The fixtures that are attached to the above Other Structures, such as fixed electro domestics, wall to wall carpets and floors; and 5. The fixtures that are in the exterior to the above Other Structures, above ground level, and used for the servicing the residence premises, such as air conditioning, water, electricity, lighting and drainage
Other Structures will automatically provide 10% of the Dwelling/Building limit. If you require more coverage in this section, please enter your request in the field.
PERSONAL PROPERTY/CONTENTS – Replacement Cost Value*
PERSONAL PROPERTY / CONTENTS Coverage is up to the limit of liability indicated on the Declaration Page for this Coverage, Personal Property owned or used by an Insured while within the Republic of Mexico. For the purpose of this coverage, Personal Property shall mean any goods of a personal nature and used by individuals in their normal life, in or out of their households, and includes furniture, articles, implements, components, utensils of dining rooms, living rooms, bedrooms, electronic equipment, electro domestics, computers, musical instruments, clothing, decorations, recreational objects, books and in general any type of personal goods inherent and usual for adequate and normal living in a household.
Personal Property/Contents will automatically provide 20% of the Dwelling/Building limit. If you require more coverage in this section, please enter your request in the field.
GLASS BREAKAGE COVERAGE:
ADDITIONAL LIVING EXPENSES*
ADDITIONAL LIVING EXPENSES If a loss covered under this section makes a part of the residence premises where you reside not fit to live in, your additional living expenses, meaning any necessary increase in your living expenses incurred by you to maintain your style or normal standard of living; Payments under this coverage will be cease at the time when the repairs of the damage or loss that originated this benefit is concluded or when the limit of liability shown on the declarations page for this coverage is exhausted, whichever occurs first.
LOSS OF RENTS*
LOSS OF RENTS At your request, and subject to payment of the corresponding additional premium, if a loss covered under this section makes the part of the residence premises rented to others or held for rental to others is not fit to live in, the fair rental value, meaning the fair value of the rent of that part of the residence premises rented to others or held for rental to others, less any expenses that do not continue while the premises are not fit to live in.(COVERAGE NOT INCLUDED DUE TO LOSSES SUSTAINED FROM CATASTROPHIC EVENTS)
DEBRIS REMOVAL*
MEDICAL*
LIABILITY – Personal Liability in Mexico*
PERSONAL LIABILITY If a claim is made in the Republic of Mexico, or a suit is brought in the courts of the Republic of Mexico, against an Insured for damages because of Bodily Injury or Property Damage caused by an Occurrence in the Republic of Mexico to which this coverage applies.
EARTHQUAKE & VOLCANIC ERUPTION*
EARTHQUAKE & VOLCANIC ERUPTION:1. Earthquake, meaning the seismic movement of land, including tremors, quakes and volcanic seismic activity; identified as such by the National Seismological Services of UNAM Mexico. 2. Volcanic Eruption, meaning losses caused by the eruption of a volcano, including the fall, avalanche or mudslide with lava, ashes or other volcanic material.
HURRICANE, WINDSTORM, FLOOD & TIDAL WAVE* (Hydro Meteorological Phenomenon)
HURRICANE, WINDSTORM, FLOOD & TIDAL WAVE:1. Hurricane, Cyclone or Windstorm, meaning wind related phenomena, such as low pressure systems,disturbances, depressions and tropical or extra tropical storms; tornadoes or whirlwinds; whether associated to hydro-meteorological phenomena or not; and, identified in the warnings or alerts of the Mexican National Meteorological Service. 2. Hailstorm, meaning the violent precipitation of hail in sufficient magnitude to be identified in the warnings or alerts of the Mexican National Meteorological Service.Flood Cover losses caused by flood, meaning the accidental and temporary covering of soil by water or mud, caused rain or by overflow or breakage of retainers for rivers, water channels, lakes, reservoirs, water tanks and natural or artificial deposits of water; excluding waters from the ocean.Tidal Waves Cover losses caused by tidal waves, meaning the accidental and temporary covering of soil by ocean waves due to hurricanes or similar wind phenomena, earthquakes or tsunamis; when identified as such by the Mexican National Meteorological Service.
SCHEDULED VALUABLES High value items may not automatically be covered under the Mexico insurance policy. If you wish to insure high value items, please submit a request.
HOW MANY VALUABLES WOULD YOU LIKE TO SCHEDULE ON YOUR POLICY?
HOW MANY SOLAR PANELS DO YOU HAVE ON YOUR PROPERTY?
ARE YOUR SOLAR PANELS ATTACHED AND BOLTED DOWN TO THE MAIN DWELLING STRUCTURE?
WHERE ARE THE BATTERIES, CONVERTORS AND OTHER RELATED SOLAR EQUIPMENT LOCATED?
1. PROPERTY TYPE
HOME CONDO TOWNHOME
2. THIS PROPERTY IN MEXICO IS USED AS?
3. OWNER USE AND RENTAL
SELECT ONE :
YES, I PLAN ON RENTING MY HOME OR CONDO IN MEXICO TO STRANGERS. YES, I AM INTERESTED IN OWNER LIABILITY PROTECTION FOR MY MEXICO VACATION RENTAL HOME OR CONDO. THIS IMPORTANT COVERAGE IS SECURED WITH A SHORT-TERM MEXICO VACATION RENTAL LIABILITY POLICY. (SEPARATE POLICY) YES, I PLAN ON RENTING MY HOME OR CONDO IN MEXICO TO STRANGERS. I AM NOT INTERESTED IN OWNER LIABILITY PROTECTION.
4. HOW MUCH TIME OF THE YEAR ARE YOU SPENDING IN MEXICO?
1. OCCUPANCY VACANCY
2. FIRE DETECTION
3. THEFT PREVENTION MEASURES
4. SECURITY
5. SECURITY - CHECK ALL THAT APPLY
24 Hour Guard
Central Alarm
Local Alarm
Bars on Windows
Bolted Security Safe
TV Circuit
Local Guard with TV Circuit
6. DOES YOUR HOME OR CONDO HAVE BARS ON THE WINDOWS?
7. IS THE HOME OR CONDO LOCATED IN A GATED COMMUNITY?
8. DOES YOUR HOME OR CONDO HAVE A CENTRAL ALARM SYSTEM EITHER LOCAL OR MONITORED
9. EXTERIOR & SAFE PROTECTION
10. FIRE DEPARTMENT
1. WHAT IS THE CONSTRUCTION OF YOUR ROOF?
2. WATER SUPPLY
3. DOES YOUR HOME or CONDO HAVE ITS OWN POOL?
(If your Pool is a community Pool located in your home or condo development, say NO.)
3. SWIMMING POOL/SPA
4. DOES YOUR HOME or CONDO HAVE ITS OWN JACUZZI?
(If your Jacuzzi is a community Jacuzzi located in your home or condo development, say NO.)
5. ARE THERE ANY STRUCTURES SURROUNDING YOUR HOME/CONDO?
6. ARE THERE ANY STRUCTURES BETWEEN YOUR HOME/CONDO AND THE SEA-LEVEL LINE?
1. FLOOD & TIDAL WATER
2. SELECT THE CLOSEST ANSWER TO THE DISTANCE YOUR PROPERTY IS LOCATED AWAY FROM ANY BODY OF WATER?
2A. PROPERTY DISTANCE TO ANY BODY OF WATER:
3. WEATHER & STORM SHUTTER PROTECTION
Approved Storm Shutters:Means, those artifacts and/or systems that
Exterior Opening(s): Means any part of a structure that is exposed to the exterior or to outside elements of nature, and that IS NOT a Wall and/or Roof made of solid durable masonry material; including but not limited to: windows, rolling windows, doors, rolling doors, garage doors, air vents and any other such openings.
Approved Materials: Any type of material, EXCEPT WOOD AND/OR GLASS that has been approved for use in a High Velocity Hurricane Zone (HVHZ) and is certified to meet the Large Missile Impact Ratings test.
Properly Installed: Means the process of placing, installing, closing and/or activating the Approved Storm Shutters in ALL Exterior Openings according to the manufacturer's product and installation specifications as filed and approved by the Florida Building Code (FBC) and/or the Miami-Dade Hurricane Authority (MDHA) mentioned above.
YES (MY STORM SHUTTERS MEET THESES REQUIREMENTS)
NO (MY STORM SHUTTERS DO NOT MEET THESE REQUIREMENTS BUT I STILL WANT TO INCLUDE HURRICANE PROTECTION ON MY HOME/CONDO.)
NO (MY STORM SHUTTERS DO NOT MEET THESE REQUIREMENTS & I DO NOT WANT HURRICANE PROTECTION)
Mexico Auto, Truck, RV, Motorcycle, UTV, ATV Insurance (U.S., Canadian & Mexico Registered) - I own or plan on purchasing a vehicle that will be in the republic of Mexico and would like to know more about Mexico auto insurance & liability protection in Mexico.
Mexico &/or Global Travel Medical Insurance (Accident & Illness) – I am interested in protecting myself/family in the event of an accident or illness while outside my/our home country of residence. (Emergency Air Evacuation Included)
Expat Major Medical Insurance – I spend or live a minimum of 6 months of the year in Mexico/Globally and I would like to see options for Expat Major Medical Insurance. (Global Health Insurance with No Borders – U.S. Coverage Included)
Global Life Insurance – I am interested in a Life Insurance policy to safe guard my family or business partner/s to pay off any outstanding loans that are on my property. (A medical exam may not be required – Easy Underwriting)
Mexico/Global Boat & Yacht Insurance - I own or plan on purchasing a boat/yacht and would like to know more about watercraft insurance & liability protection in Mexico. (California, Mexico & Global Navigational Limits Available – No Hurricane Season Black Out Dates)
Please Provide Any Additional Details About This Property That You Would Like West Coast Global Insurance Services Should Be Aware Of?
How Did You Hear About West Coast Global Insurance Services?
Friend's Name
What Was The Name Of The Location You Saw Our Company Information?
What Search Engine?
What Did You Search For? What Were The Key Words Used When Searching Online?
What Separated West Coast Global Insurance From Other Companies You Found On The Web?
I acknowledge that West Coast Real Estate & Insurance, Inc., doing business as West Coast Global Insurance Services, does not guarantee any coverages and has presented this informal application/questionnaire solely for the purpose of collecting general information. I comprehend that the submission of this informal application/questionnaire does not constitute insurance coverage for either myself or the insured item for which I am seeking information.I am aware that the coverage limits I have requested may be subject to change upon the generation of a formal quote by an insurance company. It is my responsibility to thoroughly review the coverages and policy conditions at that time. I confirm that I have read the foregoing application/questionnaire, along with any attached documents, and declare that the information provided therein is true, complete, and correct to the best of my knowledge and belief. I understand that this information serves as an inducement for the company to consider issuing an insurance policy, and no coverage is currently being offered.I acknowledge that West Coast Real Estate & Insurance, Inc., DBA West Coast Global Insurance Services, will be in communication with me to further assist with my insurance needs. I hereby grant my consent to receive telephone calls, text (SMS & MMS) messages, and email communications. I understand that providing consent is not a condition of purchase, and standard message and data rates may apply.For more information on how your data is handled, please visit our Privacy Policy. (PRIVACY POLICY) Checking this box serves as my digital signature.
Please answer this simple question so we know you are a human & then click the submit button.