SMS Opt In

Enter your phone number to opt into text messaging. By opting in, you agree to receive conversational SMS messages from Pelican Shield Insurance Group. Message frequency may vary. Standard message and data rates may apply. Reply STOP to opt out at any time. Reply HELP for assistance. No mobile opt-in or text message consent will be shared with third parties or affiliates for marketing or promotional purposes.

"*" indicates required fields

Are you a current client of our agency?*

Yes

What policy number(s) do you need help with if available?

What is the nature of your inquiry?*

General Question

ID Card Request

Policy Change Request

Discuss A Claim

Certificate of Insurance

Other

Describe your policy change request

What date do you need this policy change/request to take effect?*

Which vehicle do you need an ID card for (please enter year, make, and model)?

Year

Make

Model

Your Name*

First Last

Your Email*

Your Phone

Please list the Additional Insured and/or Certificate Holder

Additional Insured and/or Certificate Holder Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Details regarding your question, policy change, claim or other request:*

**Important: Please note completion of any request(s) for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting a request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.