Sales Opportunity Capture & Resolution Tracker

Name: Foresight Insurance, LLC
Address: 11821 Parklawn Dr, North Bethesda, MD, 20852, US
Telephone: (301) 985-2667

1) Capture info below … 2) Work call normally … 3) If resolved, complete info appropriately … 4) Submit to processing – EVEN IF OPEN!
Customer Type
- Personal
- Business
Name
Contact Info
Primary Phone
SMS Consent
By submitting this form, you agree to receive text messages and calls, including those made using AI, regarding your inquiry and related services. Standard messaging and data rates may apply.
Type of Phone
- Cell
- Home
- Work
Quote Info
- EZLynx
- IMS
- Other
If Other:
Opp. Date (MM.DD.YY)
Agent
Relationship
- Prospect
- Active Client
- Prior Client
Marketing Source
If NFM Lending Tysons or Referral Selected Above, Please Add Name:
Opportunity Information
Pol Type Cur Carrier Trans Type (NAO, New, Ren, SO, Upsell) Interest (Req, Off) Expires
List
Product/Carrier MGA App Date Eff Date Premium Term
Capture Processing
1. Referrals
On (date):
Month
Day
Year
2. Check for Resolved information to process
3. If not resolved, return form to Writing Agent
Resolution Processing
Resolution Date
Month
Day
Year
Quoted?
- Yes
- No
Preferred Acct?
- Yes
- No
Agent
Indicate Reason
If Other selected above:
1. Auto Qualification
- Check here if not qualifying auto and skip this section
a. In the past 6 months, has the applicant had continuous auto insurance?
- Yes
- No
b. Any Claims & Violations for Insured Drivers in Past 3 Years? (note: specifically ask about DUI’s and suspended/revoked license of any driver they want to insure.)
- Yes
- No
- None Admitted
Accident & Claims Details
Date Fault Driver Description
Violation Details
Date Driver Description
Discounts
- Telematics Program
- 8 Day Advance Quote Discount
- Multipolicy Discount
List Multipolicy Discount:
Auto Decision
- Run through EZLynx
- DQ Standard (Write UNSOLD reason on the last page)
- Did not ask qualifying questions
2. Residence Qualification
a. Residence
- Rent
- Own
- Other
If Other selected above:
- b. Check here if not qualifying for residence and skip the rest of this section
c. Any Animals?
- Yes
- No
- None Admitted
Animals:
Type For Dogs Only – Predominant Breed Quantity For Dogs Only – Bitten? (No, Yes, N/A)
d. Any Claims for past 5 years? (Applies to ALL properties owned or rented by ALL persons listed on the deed)
- Yes
- No
- None admitted
Claims
Date Loss Amt Description CAT Loss (No, Yes)
e. Has the property insurance been cancelled, declined or non-renewed in the last 5 years?
- Yes
- No
f. Is the home under construction?
- Yes
- No
g. Is there a swimming pool on the premises?
- Yes
- No
h. Is there a business or daycare on the premises?
- Yes
- No
If daycare, how many employees?
If other business, what type?
i. Trampoline?
- None
- With Netting
- Without Netting
j. Secondary Heating?
If yes, professionally installed?
- Yes
- No
k. Wood-burning stoves?
- Yes
- No
Quantity of wood-burning stoves:
l. Has the roof been totally replaced?
- Yes
- No
Date replaced and comments:
m. Discounts
- 8 Day Advance Quote Discount
- Sprinkler
- Burglar Alarm
- Multipolicy Discount
Type of Burglar Alarm
Type of Multipolicy Discount
n. Residence Decision
- Std: Proceed
- Non-std: Explain options
3. Auto Data Capture
- Not capturing (skip sub-steps)
a. EZLynx
- Done
- Needs to be completed
4. Residence Data Capture
- Not capturing (skip sub-steps)
a. EZLynx
- Done
- Needs to be completed
5. Need by:
- Standard (2 hours)
- URGENT
- Delayed
- N/A – Sold & written on first contact (go to Sales Results)
- N/A – Quoted on first contact (go to Sales Results)
URGENT by:
Delayed to:
Contingencies Resolved? (Yes, No)
Instructions & Notes
1. Record all known contingencies/other notes above:
- Done
- None
2. Lines to Rate (NOTE: If you check Renter and did not capture info in EZLynx, your SA will run a “standard” renter quote):
- Auto
- Home
- Renter
- Condo
- Other
If Other selected above:
3. Quote Std Carriers?
- All
- Erie
- Safeco
- Nationwide
- Progressive
- AIC
- State Auto
- TPC
4. Run rates for:
- MPD & monoline
- MPD Only
- Monoline Only
5. Special Instructions
Service Assistant Responsibilities
* For any CLUE or MVR differences, STOP processing and review with Writing Agent
1. Maryland Case Search (Erie Only)
Auto
- No Violations Found
- Violations Found
- Skipped
2. CLUE (Company Used)
Auto
- Not Ordered
- No Hit
- Match
- Acceptable
- Differs*
Res Type
- H3
- H4
- H6
Res
- Not Ordered
- No Hit
- Match
- Acceptable
- Differs*
Other:
- Not Ordered
- No Hit
- Match
- Acceptable
- Differs*
3. MVR (Company Used)
Auto
- Not Ordered
- No Hit
- Match
- Acceptable
- Differs*
4. Agent review of report discrepancies
Auto
- No discrepancies
- Applicant Called
- Disqualified-Erie
- Disqualified-Standard
Res Type
- H3
- H4
- H6
Res
- No discrepancies
- Applicant Called
- DQ-All
- Disqualified-Erie
- Disqualified-Saf
- Disqualified-NW
- Disqualified-PRO
Other:
- No discrepancies
- Applicant Called
- OK
- Disqualified-Erie
- Disqualified-Std
5. EZL: Rates Setup
Auto
- MPD
- Mono
Res Type
- H3
- H4
- H6
Res
- MPD
- Mono
6. EZL: Update Incident Data
Auto
- Done
- Not Done
Res Type
- H3
- H4
- H6
Res
- Done
- Not Done
Other
- Done
- N/A
7. EZL: Add std renter/home
Res Type
- H3
- H4
- H6
Res
- Done
- Not Requested
8. EZL: Run Quotes
All lines possible done at the same time?
- Yes
- No
Res Type
- H3
- H4
- H6
9. EZL: DL to IMS
Auto
- Done
- Not Done
Res Type
- H3
- H4
- H6
Res
- Done
- Not Done
Other
- Done
- N/A
10. Create X-date in IMS
Auto
- Done
- Not Done
Res Type
- H3
- H4
- H6
Res
- Done
- Not Done
Other
- Done
- N/A
Save Quotes to Google Drive
- Done
- Did not quote Erie
- Quoted Erie
Note IMS with Quote Results
- Done
- Not Done
Scan & Return paperwork to WA (Done by, Date, and Time):
Writing Agent: Sales Results
- UNSOLD (See first page for details)
- SOLD (See first page for details & complete tasks below)
Tasks
- Create New Business Checklist
Assign Follow Up Tasks for Service Assistant
- Cancel Prior Policy
- Assign Home Inspection Task (Erie Homes Only)
- Send App. For e-Signatures (Commercial)
Name
This field is for validation purposes and should be left unchanged.

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Contact Us

Foresight Insurance, LLC

11821 Parklawn Dr
Suite 204
North Bethesda, Maryland 20852

Phone: (301) 985-2667

Fax: (301) 985-2668

Mon-Fri: 9:30am-5:00pm
Sat-Sun: Closed

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Foresight Insurance, LLC Provides auto, home, life, and business / commercial insurance to All of Maryland, Including Rockville, Bethesda, and Gaithersburg.

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Pol Type	Cur Carrier	Trans Type (NAO, New, Ren, SO, Upsell)	Interest (Req, Off)	Expires

Type	For Dogs Only – Predominant Breed	Quantity	For Dogs Only – Bitten? (No, Yes, N/A)

Product/Carrier	MGA	App Date	Eff Date	Premium	Term

Date	Fault	Driver	Description

Date	Driver	Description

Date	Loss Amt	Description	CAT Loss (No, Yes)

Sales Opportunity Capture & Resolution Tracker

Contact Info

Capture Processing

Resolution Processing

1. Auto Qualification

2. Residence Qualification

3. Auto Data Capture

4. Residence Data Capture

Instructions & Notes

Service Assistant Responsibilities