“Quick Quote"

Click “Quick Quote" above to begin your client's application for a preliminary rate and print out the application for completion.  Firm pricing is determined on a fully underwritten application.  Online submissions are available via RLI Direct Portal access.

Applications & Forms

No need to submit Dec Pages or MVR's!

New Hampshire Clients

                NH Primary Resident Current Application

                NH UM-UIM Rejection Form (PUP 261-0111)

 Massachusetts Clients

                MA Current Application & Rate Sheet

                MA UM-UIM Purchase or Rejection Form (PUP 261-0111)

Auto Endorsement Form

Insured Payment Authorization Form

Where to Submit Completed Applications?

Secure Submission Portal – Upload the insured's completed application and payment authorization form using the submission portal on this page.  Angelina will receive securely and no need to mail it to us!

Direct Access to Complete, sign & Pay on the RLI Website

Member Agents may access the RLI website directly.  “PUP ACCESS" gives you the ability to submit/quote applications, send to the insured for Review, eSignature and Payment …plus gain access to Policy Status, Billing Info, Policy Documents.  To obtain PUP ACCESS or learn more, contact Angelina Coelho at (508) 634-7360. 

Mail Submissions

Forward completed RLI applications with a FULL premium check (payable to RLI):

RLI c/o Number One Insurance Agency
91 Cedar Street
Milford, MA 01757

Not a Fit with RLI? Try an alternative market Endorsed by IIABA: Anderson & Murison (A&M).  – I'd want the “Anderson & Murison (A&M)" to be a hyperlink to the A&M page built above.

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