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[Pages:1]Insurance Comparison Worksheet

Where you will keep the car?_____________________________________________________________

____________________________________________________________________________________

Driver(s)

Age Sex Marital Status Violations and Accidents (last 3 years)

#1

#2

#3

Vehicle (year, make, model): _____________________________________________________________ Miles driven to work:___________________________________________________________________ Annual mileage: _______________________________________________________________________ Miles of principal driver: ________________________________________________________________

Level of Coverage

Company A

Bodily Injury Liability/Property-Damage Liability:

Personal-Injury Protection ("PIP"):

Uninsured/Underinsured Motorist ("UM/UIM"):

Collision Coverage:

Comprehensive Coverage:

Other (Misc. Coverages):

Membership Fees:

Total:

Company B

Company C

Minnesota requires you to carry the following minimum insurance: $30,000 per person and $60,000 per accident for bodily injury and $10,000 for property damage liability; $40,000 for personal injury protection ("PIP"); and $25,000 per person and $50,000 per accident for uninsured/underinsured coverage.

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