Miller Insurance

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Our Insurance Products

RV Insurance

Thank you for inquiring about insurance coverage through Miller Insurance Agency. We have been doing business for over 40 years and are experts in the insurance industry. We write policies in most States across the Nation and represent several insurance carriers including those that offer full-time RV insurance coverage. This allows us to compare the available products and offer you the best options.

Are you interested in receiving a free quote?

Kindly fill out the interview sheet, and we will process your request.

RV and Auto Quote Sheet

1STEP 1
Your Info

2STEP 2
Basic Personal Info

Applicant Information

Please be sure to fill out the form completely, all of the information is necessary to provide you with the most accurate quote possible.

Name(Required)

Reg. Owner(Required)

Yes

No

Gender(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Driver's License #(Required)

St(Required)

Primary Phone(Required)

Cell Phone

E-mail Address(Required)

Marital Status(Required)

Level of Education

Safe driver course in the past 3 yrs?

Yes

No

Occupation

Add Another Applicant?

Yes

No

Co-Applicant Information

Please be sure to fill out the form completely, all of the information is necessary to provide you with the most accurate quote possible.

Name(Required)

Reg. Owner(Required)

Yes

No

Gender(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Driver's License #(Required)

St(Required)

Primary Phone

Cell Phone

Email Address

Marital Status(Required)

Level of Education

Driver Information

Please be sure to fill out the form completely, all of the information is necessary to provide you with the most accurate quote possible.

Good Sam Member?(Required)

Yes

No

Good Sam Emergency Road Service?(Required)

Yes

No

Good Sam Extended Service plan?(Required)

Yes

No

AAA member?(Required)

Yes

No

USAA Member?(Required)

Yes

No

Military?(Required)

Yes

No

Club Member(Required)

Drive for Lyft/Uber?(Required)

Yes

No

Auto or RV used for any deliveries?(Required)

Yes

No

Drive for a Transport Co?(Required)

Yes

No

Claim Record for Driver #1

Do you plan to rent the RV?(Required)

Yes

No

Claim Record for Driver #2

ANY other Drivers in Household?(Required)

Yes

No

Relation

Do you have an active owner-occupied homeowner’s policy?(Required)

Yes

No

Carrier

What state is your house in?

House Type

Basic Property Information

Please be sure to fill out the form completely, all of the information is necessary to provide you with the most accurate quote possible.

Where do you get your mail?(Required)

Association to this address?(Required)

Street Address(Required)

Mailing City(Required)

Mailing State(Required)

Zip(Required)

Garaging same as mailing?(Required)

Yes

No

Association to this address(Required)

Address(Required)

City(Required)

State(Required)

Zip(Required)

Fulltiming?(Required)

Yes

No

Registration Address

Is registration same as mailing?(Required)

Yes

No

Name of Registration

Association to this address

Address

City

State

Zip

Is the RV in an LCC or Trust?

Yes

No

Name of Trust or LCC

Address

City

State

Zip

Vehicle Information

Class of Vehicle(Required)

Motorhome

Travel Trailer

5th Wheel

Med Duty TK

Vin#

Annual Mileage

Purchase Date(Required)

Purchase Price(Required)

Year(Required)

Make(Required)

Model(Required)

Series

Length(Required)

Horse Power

No. of slides

Fuel(Required)

Gas

Diesel

Purchased from a(Required)

Dealership

Private Party

No. of days used / yr.(Required)

Purchased(Required)

New

Used

First Owner?(Required)

Yes

No

Full-timer?(Required)

Yes

No

Theft Alarm?

Yes

No

Personal Effects? $

RV Driving Experience in Years(Required)

Primary RV Driver?(Required)

Is the RV permanently parked all year with the intent not to move the RV?(Required)

Yes

No

Where do you have Tow/Roadside?

When RV is not being used, where is it parked?

Locked Garage

Carport

RV Pad

Outside storage

Inside Storage

Somewhere else?

Is the RV the only vehicle in the household?(Required)

Yes

No

Business usage?(Required)

Yes

No

Loan on RV?(Required)

Yes

No

Current RV Vehicle Insurance

Name of carrier on RV?

Expiration of RV insurance

Name of Carrier on Auto?

Expiration of Auto Insurance

Why are you considering leaving your current carrier?

Carrier Limits

Number of years with this carrier?

Current Price $

6th or 12th month policy?

6th

12th

Would you like to add an auto?

Yes

No

Automobile/Truck #1

Loan

Yes

No

VIN#

Year

Odometer

Annual Mileage

Make

Model

Auto Breaking?

Yes

No

Blind Spot Detection?

Yes

No

Purchased

New

Used

Purchased Date

Series

Add another auto?

Yes

No

Automobile/Truck #2

Loan

Yes

No

VIN#

Year

Odometer

Annual Mileage

Make

Model

Auto Breaking?

Yes

No

Blind Spot Detection?

Yes

No

Purchased

New

Used

Purchased Date

Series

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get in touch Maintaining a Personal
Relationship with Each Client.

Call us today and see how we can help you with the coverage you need.

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OUR PRODUCTS
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HOME
OUR PRODUCTS
ABOUT US
CONTACT US

5805 Willow Ln,
Lake Oswego, OR 97035

info@millerrvinsurance.com

503-699-9348

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Confirmation of Your Insurance Inquiry and Next Steps

Thank you for visiting Miller Insurance Agency’s web site and inquiring about insurance coverage.

We have received your information and we will be in the process of checking with our carriers for policies to
match your needs.

Once our research is completed we will contact you with our proposal.

Miller Insurance Agency Team